| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT E. MILLER INSURANCE AGENCY3 | 6363 COLLEGE BOULEVARD, SUITE 400 OVERLAND PARK, KS 66211 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 4.97% |
| ROBERT E. MILLER INSURANCE AGENCY3 | 6363 COLLEGE BOULEVARD, SUITE 400 OVERLAND PARK, KS 66211 | UNITED HEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 8.64% |
| KENNETH SIGMAN3 | 6363 COLLEGE BOULEVARD, SUITE 400 OVERLAND PARK, KS 66211 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.23% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $917 | $412 | $1K | 3.04% |
| ROBERT E. MILLER INSURANCE AGENCY3 | 6363 COLLEGE BOULEVARD, SUITE 400 OVERLAND PARK, KS 66211 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.11% |
| HEALTH AND BENEFIT SYSTEMS, INC.3 Filed as: HEALTH AND BENEFIT SYSTEMS | 10740 NALL AVENUE, SUITE 101 LEAWOOD, KS 66207 | MISSOURI EYE CARE ALLIANCE DBA VISION CARE DIRECT | $2K | — | $2K | 10.00% |
| ROBERT E. MILLER INSURANCE AGENCY3 | 6363 COLLEGE BOULEVARD, SUITE 400 OVERLAND PARK, KS 66211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| ROBERT E. MILLER INSURANCE AGENCY3 | 6363 COLLEGE BOULEVARD, SUITE 400 OVERLAND PARK, KS 66211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $706 | — | $706 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAN HEALTH EIN 16-1264154 HEALTH ADMINISTRATOR | Contract Administrator Service code 13 | — | $76K |
| ROBERT E. MILLER INSURANCE AGENCY INSURANCE BROKER | Insurance agents and brokers Service code 22 | 6363 COLLEGE BOULEVARD OVERLAND PARK, KS 66211 | $65K |
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 | 379 | 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) | 379 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 196 | $69K |
| Vision | MISSOURI EYE CARE ALLIANCE DBA VISION CARE DIRECT | 151 | $19K |
| Life insurance | UNITED HEALTHCARE INSURANCE COMPANY | 358 | $46K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 35 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 35 | $10K |
| Stop-loss / reinsurancereinsurance | STANDARD LIFE INSURANCE COMPANY OF NEW YORK | 188 | $589K |
| Other(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 358 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 358 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.