| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BUKATY COMPANIES3 | 11221 ROAE STE 200 LEAWOOD, KS 66211 | UNION SECURITY INSURANCE COMPANY (VISION) | $6K | $4K | $10K | 16.92% |
| DAVID W WIGGINS | 3400 EASTVALE FAIRWAY, KS 66205 | TRUSTMARK INSURANCE COMPANY | $38K | — | $38K | 78.18% |
| BUKATY COMPANIES3 | 11221 ROE STE 200 LEAWOOD, KS 66211 | UNION SECURITY INSURANCE COMPANY (LTD) | $9K | $4K | $13K | 28.11% |
| BUKATY COMPANIES3 | 11221 ROE STE 200 LEAWOOD, KS 66211 | UNION SECURITY INSURANCE COMPANY (GTL/ADD) | — | $3K | $3K | 7.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF KANSAS CITY EIN 57-0287419 PROVIDES CLAIMS ADMIN | Contract Administrator Service code 13 | ONE PERSHING SQUARE 2501 MAIN PO BOX 419169 KANSAS CITY, MO 641416169 | $371K |
| COVENTRY HEALTH CARE, INC. EIN 48-0840330 PROVIDES CLAIMS ADMIN | Contract Administrator Service code 13 | 750 PRIDES CROSSING SUITE 200 NEWARK, DE 19713 | $64K |
| MEDTRAK SERVICES, LLC EIN 36-4221427 PROVIDES CLAIMS ADMIN | Claims processing Service code 12 | 7101 COLLEGE BLVD STE 1000 OVERLAND PARK, KS 66210 | $30K |
| DELTA DENTAL OF KANSAS EIN 48-0793267 PROVIDES CLAIMS ADMIN | Contract Administrator Service code 13 | 1619 N WATERFRONT PARKWAY PO BOX 789769 WICHITA, KS 67278 | $22K |
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 | 888 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 645 | $115K |
| Vision | UNION SECURITY INSURANCE COMPANY (VISION) | 335 | $59K |
| Life insurance | UNION SECURITY INSURANCE COMPANY (GTL/ADD) | 888 | $39K |
| Short-term disability(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY (TEMP) | 589 | $107K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY (LTD) | 261 | $47K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 645 | $115K |
| Other | UNION SECURITY INSURANCE COMPANY (GTL/ADD) | 888 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 888 | — |
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.