| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORESOURCE, INC.3 Filed as: CORESOURCE | 18401 MAPLE CREEK DRIVE, SUITE 300 TINLEY PARK, IL 60477 | HCC LIFE INSURANCE COMPANY | $520 | — | $520 | 0.27% |
| USI INSURANCE SERVICES LLC3 | 245 N WACO ST, STE 300 WICHITA, KS 67202 | HCC LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST VIRGINIA BEACH, VA 23462 | HARTFORD LIFE AND ACCIDENT | $8K | — | $8K | 11.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, LLC | 245 N WACO SUITE 300 WICHITA, KS 67202 | DELTA DENTAL OF KANSAS, INC. | $401 | — | $401 | 1.25% |
| GAIL COE3 | 4600 FARMSTEAD CT BEL AIRE, KS 67220 | AFLAC | $552 | $20 | $572 | 12.89% |
| USI INSURANCE SERVICES LLC3 | PO BOX 206 WICHITA, KS 67201 | AFLAC | $208 | — | $208 | 4.69% |
| CALEB GILMOUR3 | 515 S MAIN ST, STE 105 WICHITA, KS 67202 | AFLAC | $91 | $4 | $95 | 2.14% |
| SAMUEL A MCFALL3 Filed as: SAMUEL MCFALL | 609 N BROADWAY ST, STE 200 WICHITA, KS 67214 | AFLAC | $25 | — | $25 | 0.56% |
| KATHY WIEDEMANN3 | 220 HIGH VIEW DR BOULDER, CO 80304 | AFLAC | $24 | — | $24 | 0.54% |
| JUSTIN C CARSON3 Filed as: JUSTIN CARSON | 7701 E KELLOGG DR, STE 680 WICHITA, KS 67207 | AFLAC | $21 | — | $21 | 0.47% |
| VARIOUS3 | — | AFLAC | $10 | — | $10 | 0.23% |
| WILLINGHAM INC3 | 1502 N METCALF LOUSIBURG, KS 66053 | AFLAC | $7 | — | $7 | 0.16% |
| GAIL COE3 | 4600 FARMSTEAD CT WICHITA, KS 67220 | AFLAC | $212 | — | $212 | 6.27% |
| USI INSURANCE SERVICES LLC3 | P O BOX 206 WICHITA, KS 67201 | AFLAC | $73 | — | $73 | 2.16% |
| VARIOUS3 | — | AFLAC | $45 | — | $45 | 1.33% |
| SAMUEL A MCFALL3 Filed as: SAMUEL MCFALL | 609 N BROADWAY WICHITA, KS 67214 | AFLAC | $33 | — | $33 | 0.98% |
| HOLLY A. TIMMERMEYER3 Filed as: HOLLY TIMMERMEYER | 4164 DANBURY ST BEL AIRE, KS 67220 | AFLAC | $17 | — | $17 | 0.50% |
| JUSTIN C CARSON3 Filed as: JUSTIN CARSON | 7701 E KELLOGG DRIVE STE 680 WICHITA, KS 67207 | AFLAC | $12 | — | $12 | 0.35% |
| KATHY WIEDEMANN3 Filed as: KATHY WIEDEMAN | 220 HIGH VIEW DRIVE BOULDER, CO 80304 | AFLAC | $9 | — | $9 | 0.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE, INC EIN 35-1846036 TPA | Claims processing Service code 12 | 6240 SPRINT PKWY STE 400 OVERLAND PARK, KS 66251 | $83K |
| USI INSURANCE SERVICES, LLC EIN 13-3771734 INSURANCE AGENT | Consulting (general) Service code 16 | P.O. BOX 206 WICHITA, KS 67201 | $36K |
| DELTA DENTAL OF KANSAS EIN 48-0793267 PRECERTIFICATION | Claims processing Service code 12 | 1619 N WATERFRONT PARKWAY WICHITA, KS 672789769 | $32K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 118 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KANSAS, INC. | 53 | $32K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 118 | $68K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 118 | $68K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 87 | $190K |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 118 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 118 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.