| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTER-AMERICAS INSURANCE CORP, INC3 | 1035 S 183RD ST GODDARD, KS 67052 | HCC LIFE INSURANCE COMPANY | $67K | — | $67K | 10.00% |
| RISK & INSURANCE CONSULTING SERVICE3 | 5500 LILBURN STONE MOUNTAIN RD STONE MOUNTAIN, GA 30087 | HCC LIFE INSURANCE COMPANY | $34K | — | $34K | 5.00% |
| OOSI3 | 1 NW OOIDA DRIVE GRAIN VALLEY, MO 64029 | AMERICAN UNDERWRITERS LIFE INSURANCE COMPANY | $1K | — | $1K | 19.75% |
| INTER-AMERICAS INSURANCE CORP, INC3 Filed as: INTER-AMERICAS INSURANCE CORP | 1035 S 183RD ST W GODDARD, KS 67052 | AMERICAN UNDERWRITERS LIFE INSURANCE COMPANY | $353 | — | $353 | 5.00% |
| BRUCE FLOYD WELNER3 | 146 N KARREN CT WICHITA, KS 67212 | AMERICAN UNDERWRITERS LIFE INSURANCE COMPANY | $141 | — | $141 | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREFERRED HEALTH PROFESSIONAL EIN 20-1665464 NONE | Direct payment from the plan Service code 50 | 8140 WARD PARKWAY STE 430 KANSAS CITY, MO 64114 | $738K |
| CHILDRENS MERCY HOSPITAL EIN 44-0605373 NONE | Direct payment from the plan Service code 50 | 2401 GILLHAM ROAD KANSAS CITY, MO 64108 | $556K |
| CENTERPOINT MEDICAL CENTER OF EIN 45-0503121 NONE | Direct payment from the plan Service code 50 | PO BOX 409786 ATLANTA, GA 30384 | $423K |
| LEEHAR DISTRIBUTORS INC EIN 43-0912223 NONE | Direct payment from the plan Service code 50 | 680 CRAIG RD STE 200 CREVE COEUR, MO 63141 | $421K |
| UNIVERSITY OF KANSAS HOSPITAL AUTH EIN 48-1202402 NONE | Direct payment from the plan Service code 50 | PO BOX 804402 KANSAS CITY, MO 64180 | $327K |
| ST MARYS MEDICAL CENTER EIN 43-1284526 NONE | Direct payment from the plan Service code 50 | PO BOX 412862 KANSAS CITY, MO 64141 | $156K |
| MIDWEST DIVISION RMC LLC EIN 54-2092552 NONE | Direct payment from the plan Service code 50 | PO BOX 404193 ATLANTA, GA 30384 | $101K |
| SURGERY CENTER OF INDEPENDENCE EIN 20-0670748 NONE | Direct payment from the plan Service code 50 | 19550 EAST 39TH STREET STE 100 INDEPENDENCE, MO 64057 | $87K |
| ST LUKES SURGICENTER EIN 47-0853481 NONE | Direct payment from the plan Service code 50 | PO BOX 419668 KANSAS CITY, MO 64141 | $74K |
| MIDWEST DIVISION-LRHC LLC EIN 48-1301817 NONE | Direct payment from the plan Service code 50 | PO BOX 404920 ATLANTA, GA 30384 | $71K |
| KANSAS UNIVERSITY PHYSICIANS EIN 48-1163756 NONE | Direct payment from the plan Service code 50 | 3901 RAINBOW BOULEVARD KANSAS CITY, KS 66160 | $70K |
| THE REHABILITATION INSTITUTE EIN 44-0552045 NONE | Direct payment from the plan Service code 50 | 3011 BALTIMORE AVE KANSAS CITY, MO 64108 | $64K |
| MIDWEST DIVISION LSH LLC EIN 45-0503141 NONE | Direct payment from the plan Service code 50 | PO BOX 404917 ATLANTA, GA 303844917 | $61K |
| NEURO INTERVENTIONAL & DIAGNOSTIC EIN 26-0376717 NONE | Direct payment from the plan Service code 50 | PO BOX 843709 KANSAS CITY, MO 64184 | $59K |
| ST JOSEPH HEALTH CENTER EIN 44-0546292 NONE | Direct payment from the plan Service code 50 | PO BOX 804465 KANSAS CITY, MO 64180 | $50K |
| HANNEMAN & WARD DDS EIN 43-1765278 NONE | Direct payment from the plan Service code 50 | 655 RD MIZE RD GRAIN VALLEY, MO 64029 | $37K |
| LABONE INC EIN 43-1039532 NONE | Direct payment from the plan Service code 50 | 10101 RENNER BLVD LENEXA, KS 66219 | $37K |
| NORTH KANSAS CITY HOSPITAL EIN 44-6005747 NONE | Direct payment from the plan Service code 50 | 2800 CLAY EDWARDS DRIVE N KANSAS CITY, MO 64116 | $36K |
| ANESTHESIA ASSOC OF KC, PC EIN 43-0975680 NONE | Direct payment from the plan Service code 50 | PO BOX 801185 KANSAS CITY, MO 641801185 | $27K |
| TRUMAN MED CENTER INC EIN 44-0661018 NONE | Direct payment from the plan Service code 50 | PO BOX 957973 ST LOUIS, MO 63195 | $21K |
| SIGNATURE MEDICAL GROUP EIN 45-3074284 NONE | Direct payment from the plan Service code 50 | 12639 OLD TESSON RD STE 100 ST LOUIS, MO 63128 | $18K |
| ST. MARYS MEDICAL CENTER EIN 47-2264005 NONE | Direct payment from the plan Service code 50 | PO BOX 874456 KANSAS CITY, MO 64187 | $16K |
| DIAGNOSTICS IMAGING CENTER PA EIN 43-0913846 NONE | Direct payment from the plan Service code 50 | 7101 COLLEGE BLVD STE 1200 OVERLAND PARK, KS 66210 | $15K |
| JULIE LOECKER DDS EIN 20-0264284 NONE | Direct payment from the plan Service code 50 | 1424 SW EAGLES PARK WAY GRAIN VALLEY, MO 64029 | $14K |
| BALANCED BODY CHIROPRACTIC CTR PC EIN 43-1717240 NONE | Direct payment from the plan Service code 50 | 19301 US 40 HWY E STE B INDEPENDENCE, MO 64055 | $12K |
| ASSOCIATED WOMENS CARE PHYSICIANS P EIN 43-0991918 NONE | Direct payment from the plan Service code 50 | PO BOX 871406 KANSAS CITY, MO 64187 | $12K |
| SAINT LUKES NORTHLAND HOSPITAL EIN 44-0565393 NONE | Direct payment from the plan Service code 50 | 601 SOUTH 169 HIGHWAY SMITHVILLE, MO 64089 | $12K |
| EDGEPARK SURGICAL INC EIN 34-1650951 NONE | Direct payment from the plan Service code 50 | 1810 SUMMIT COMMERCE PARK TWINSBURG, OH 44087 | $11K |
| SHAWNEE MISSION MEDICAL CENTER EIN 48-0637331 NONE | Direct payment from the plan Service code 50 | 9100 W 74TH ST SHAWNEE MISSION, KS 66204 | $11K |
| ALAN J FOSTER DDS PC EIN 43-1872495 NONE | Direct payment from the plan Service code 50 | 2150 NW SOUTH OUTER RD BLUE SPRINGS, MO 64015 | $11K |
| CROSSROADS OF KANSAS CITY EIN 43-1777825 NONE | Direct payment from the plan Service code 50 | 14310 EAST 42ND ST SOUTH INDEPENDENCE, MO 64114 | $11K |
| ENCOMPASS MEDICAL GROUP PA EIN 48-1229965 NONE | Direct payment from the plan Service code 50 | PO BOX 413147 KANSAS CITY, MO 64141 | $11K |
| PRIME HEALTHCARE KANSAS CITY EIN 47-2538324 NONE | Direct payment from the plan Service code 50 | 801 NW ST MARYS DR STE 220 BLUE SPRINGS, MO 64014 | $10K |
| SAINT LUKES MEDICAL GP LEES SUMMIT EIN 43-1598353 NONE | Direct payment from the plan Service code 50 | PO BOX 504938 ST LOUIS, MO 63150 | $9K |
| MIDWEST DIVISION - MMC LLC EIN 48-1301826 NONE | Direct payment from the plan Service code 50 | 5721 W 119TH ST OVERLAND PARK, KS 66209 | $9K |
| ROCKHILL ORTHOPAEDIC SPEC EIN 45-3851008 NONE | Direct payment from the plan Service code 50 | PO BOX 843236 KANSAS CITY, MO 64184 | $9K |
| HORIZON ORTHOTIC & PROSTHETIC EIN 20-5132974 NONE | Direct payment from the plan Service code 50 | 11775 W 112TH ST STE 101 OVERLAND PARK, KS 66210 | $9K |
| HAUSHEER BRABY ASSOCIATES EIN 43-0971441 NONE | Direct payment from the plan Service code 50 | 19550 E 39TH ST STE 310 INDEPENDENCE, MO 64057 | $9K |
| MYRIAD GENETIC LABORATORIES EIN 87-0514323 NONE | Direct payment from the plan Service code 50 | 320 WAKARA WAY SALT LAKE CITY, UT 84108 | $8K |
| ST LUKES EAST ANESTHESIA SERVICE PC EIN 20-1310868 NONE | Direct payment from the plan Service code 50 | PO BOX 412431 KANSAS CITY, MO 64141 | $8K |
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 | 307 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMERICAN UNDERWRITERS LIFE INSURANCE COMPANY | 312 | $7K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 312 | $670K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 312 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.