| 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 | — | — | $0 | 0.00% |
| 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 | $7K | — | $7K | 12.22% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, LLC | 245 N WACO SUITE 300 WICHITA, KS 67202 | DELTA DENTAL OF KANSAS, INC. | $2K | — | $2K | 5.17% |
| GAIL COE3 | 4600 FARMSTEAD CT BEL AIRE, KS 67220 | AFLAC | $421 | $12 | $433 | 10.41% |
| USI INSURANCE SERVICES LLC3 | PO BOX 206 WICHITA, KS 67201 | AFLAC | $206 | — | $206 | 4.95% |
| BRANDON UNREIN3 | 15275 SW INDIANOLA RD AUGUSTA, KS 67010 | AFLAC | $75 | — | $75 | 1.80% |
| CALEB GILMOUR3 | 515 S MAIN ST, STE 105 WICHITA, KS 67202 | AFLAC | $65 | $2 | $67 | 1.61% |
| SAMUEL A MCFALL3 Filed as: SAMUEL MCFALL | 609 N BROADWAY ST, STE 200 WICHITA, KS 67214 | AFLAC | $23 | — | $23 | 0.55% |
| JUSTIN C CARSON3 Filed as: JUSTIN CARSON | 7701 E KELLOGG DR, STE 680 WICHITA, KS 67207 | AFLAC | $21 | — | $21 | 0.51% |
| KATHY WIEDEMANN3 | 220 HIGH VIEW DR BOULDER, CO 80304 | AFLAC | $19 | — | $19 | 0.46% |
| WILLINGHAM INC3 | 1502 N METCALF LOUSIBURG, KS 66053 | AFLAC | $7 | — | $7 | 0.17% |
| GAIL A COE3 | 4600 FARMSTEAD CT BEL AIRE, KS 67220 | AFLAC | $196 | — | $196 | 6.92% |
| VARIOUS3 | — | AFLAC | $126 | — | $126 | 4.45% |
| USI INSURANCE SERVICES LLC3 | PO BOX 206 WICHITA, KS 67201 | AFLAC | $107 | — | $107 | 3.78% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE, INC EIN 35-1846036 TPA | Plan Administrator; Claims processing; Other services Service code 12 | 6240 SPRINT PKWY STE 400 OVERLAND PARK, KS 66251 | $42K |
| DELTA DENTAL OF KANSAS EIN 48-0793267 PRECERTIFICATION | Other services; Claims processing Service code 12 | 1619 N WATERFRONT PARKWAY WICHITA, KS 672789769 | $37K |
| USI INSURANCE SERVICES, LLC EIN 13-3771734 INSURANCE AGENT | Insurance agents and brokers; Consulting (general) Service code 16 | P.O. BOX 206 WICHITA, KS 67201 | $37K |
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 | 124 | 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) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KANSAS, INC. | 56 | $37K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 124 | $58K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 124 | $58K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 89 | $206K |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 124 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 124 | — |
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."
No prospect flags tripped on this filing.