| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DONALD L SOUTHWORTH3 | 9604 STATE LINE ROAD LEAWOOD, KS 66206 | STANDARD INSURANCE COMPANY | $86K | $19K | $106K | 3.65% |
| DONALD L SOUTHWORTH3 | 9604 STATE LINE ROAD LEAWOOD, KS 66206 | STANDARD INSURANCE COMPANY | $179K | $17K | $196K | 13.22% |
| DONALD L SOUTHWORTH3 | 9604 STATE LINE ROAD LEAWOOD, KS 66206 | STANDARD INSURANCE COMPANY | $38K | $10K | $48K | 3.76% |
| IOWA BANKERS INSURANCE AND SERVICES3 Filed as: IOWA BANKERS INS & SERVICES | PO BOX 6210 JOHNSTON, IA 501316210 | VERATRUS BUSINESS SOLUTIONS | $35K | — | $35K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 42-0318333 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $4.4M |
| DELTA DENTAL EIN 42-0959302 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $356K |
| DAVIS, BROWN, KOEHN LAW FIRM EIN 42-1343884 NONE | Legal; Direct payment from the plan Service code 29 | — | $24K |
| DELOITTE & TOUCHE LLP EIN 13-3891517 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $6K |
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 | 31,263 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 708 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 240 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 32,211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VERATRUS BUSINESS SOLUTIONS | 1,915 | $354K |
| Life insurance | STANDARD INSURANCE COMPANY | 9,249 | $2.9M |
| Short-term disability | STANDARD INSURANCE COMPANY | 5,173 | $1.3M |
| Long-term disability | STANDARD INSURANCE COMPANY | 8,765 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,249 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.