| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS ST VIRGINIA BEACH, VA 23462 | HARTFORD LIFE AND ACCIDENT | $9K | — | $9K | 11.67% |
| USI INSURANCE SERVICES LLC3 | 245 N WACE SUITE 300 WICHITA, KS 67202 | DELTA DENTAL OF KANSAS, INC. | $428 | — | $428 | 1.25% |
| GAIL COE3 | 4600 FARMSTEAD CT BEL AIRE, KS 67220 | AFLAC | $226 | $14 | $240 | 10.97% |
| JULIAN DUARTE3 | 412 N MYRTLE ST EUREKA, KS 67045 | AFLAC | $165 | — | $165 | 7.54% |
| CALEB GILMOUR3 | 515 S MAIN ST, STE 105 WICHITA, KS 67202 | AFLAC | $49 | $3 | $52 | 2.38% |
| USI INSURANCE SERVICES LLC3 | PO BOX 206 WICHITA, KS 67201 | AFLAC | $22 | — | $22 | 1.01% |
| SAMUEL A MCFALL3 Filed as: SAMUEL MCFALL | 609 N BROADWAY ST, STE 200 WICHITA, KS 67214 | AFLAC | $12 | — | $12 | 0.55% |
| NICOLE E ROONEY3 | 515 S MAIN ST STE 105 WICHITA, KS 67202 | AFLAC | $8 | $3 | $11 | 0.50% |
| KATHY WIEDEMANN3 | 220 HIGH VIEW DR BOULDER, CO 80304 | AFLAC | $7 | — | $7 | 0.32% |
| JUSTIN C CARSON3 Filed as: JUSTIN CARSON | 7701 E KELLOGG DR, STE 680 WICHITA, KS 67207 | AFLAC | $5 | — | $5 | 0.23% |
| WILLINGHAM INC3 | 1502 N METCALF LOUSIBURG, KS 66053 | AFLAC | $3 | — | $3 | 0.14% |
| MISCELLANEOUS AGENTS Filed as: MISCELLANEOUS | — | AFLAC | $2 | — | $2 | 0.09% |
| JULIAN DUARTE3 | 412 N MYRTLE ST EUREKA, KS 67045 | AFLAC | $159 | — | $159 | 10.90% |
| VARIOUS3 | — | AFLAC | $59 | — | $59 | 4.04% |
| GAIL A COE3 | 4600 FARMSTEAD CT BEL AIRE, KS 67220 | AFLAC | $57 | — | $57 | 3.91% |
| USI INSURANCE SERVICES LLC3 | PO BOX 206 WICHITA, KS 67201 | AFLAC | $29 | — | $29 | 1.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $68K |
| USI INSURANCE SERVICES, LLC EIN 13-3771734 BROKER | Other commissions Service code 55 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | $27K |
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 | 123 | 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) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF KANSAS, INC. | 56 | $35K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 123 | $78K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 123 | $78K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 90 | $214K |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 123 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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.