| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 600 KANSAS CITY, MO 64112 | BLUECROSS BLUESHIELD OF KANSAS CITY | $47K | $220K | $267K | 1.84% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCIATES, INC. | 3001 WESTOWN PARKWAY WEST DES MOINES, IA 50266 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $190K | — | $190K | 14.08% |
| DG3 NORTH AMERICA INC5 Filed as: DG3 NORTH AMERICA INC. | PO BOX 83090 CHICAGO, IL 60691 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 0.10% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCIATES, INC. | 6300 W 143RD STREET, SUITE 200 OVERLAND PARK, KS 66223 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $2K | $14K | 17.77% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHSTAT, INC. EIN 56-2273744 WELLNESS CONSULTING | Consulting (general) Service code 16 | — | $475K |
| DELTA DENTAL EIN 43-0908349 DENTAL ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $61K |
| PRUDENTIAL INSURANCE COMPANY EIN 22-1211670 STD ADMINISTRATOR | Contract Administrator Service code 13 | — | $18K |
| PAYFLEX EIN 91-1774434 FSA ADMINISTRATOR | Contract Administrator Service code 13 | — | $11K |
| COMPSYCH EIN 35-3739783 ADMINISTRATOR | Contract Administrator Service code 13 | — | $0 |
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 | 1,364 | 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) | 1,364 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF KANSAS CITY | 3,218 | $14.5M |
| Vision | SURENCY LIFE AND HEALTH | 815 | $134K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,456 | $1.3M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,456 | $1.3M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,456 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,218 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.