| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE LEGACY BENEFITS GROUP3 Filed as: LEGACY BENEFITS GROUP, INC. | 7903 KEVIN LANE BELTON, MO 64012 | DELTA DENTAL OF MISSOURI | $5K | — | $5K | 4.99% |
| ROBERT E. MILLER INSURANCE AGENCY3 | 6363 COLLEGE BOULEVARD, SUITE 400 OVERLAND PARK, KS 66211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| ROBERT E. MILLER INSURANCE AGENCY3 | 6363 COLLEGE BOULEVARD, SUITE 400 OVERLAND PARK, KS 66211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 20.00% |
| ROBERT E. MILLER INSURANCE AGENCY3 | 6363 COLLEGE BOULEVARD, SUITE 400 OVERLAND PARK, KS 66211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| ROBERT E. MILLER INSURANCE AGENCY3 | 6363 COLLEGE BOULEVARD, SUITE 400 OVERLAND PARK, KS 66211 | VISION SERVICE PLAN | $765 | — | $765 | 7.34% |
| THE STINGRAY GROUP INC3 Filed as: THE STINGRAY GROUP, INC. | 7324 RICHARDS DRIVE SHAWNEE, KS 66216 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $300 | — | $300 | 20.89% |
| THOMAS MCGEE LLC3 Filed as: THOMAS MCGEE, LLC | P.O. BOX 419013 KANSAS CITY, MO 64141 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 3.62% |
| RON BOWLING3 | 8575 W. 110TH STREET OVERLAND PARK, KS 66210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | $8 | $32 | 2.23% |
| RYAN BOWLING3 | 8575 W. 110TH STREET OVERLAND PARK, KS 66210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $10 | $21 | 1.46% |
| MARIYLN BOWLING3 | 8447 SUMMIT STREET LENEXA, KS 66215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $5 | $16 | 1.11% |
| MAUREEN E CONRAN3 Filed as: MAUREEN E. CONRAN | 8575 W. 110TH STREET OVERLAND PARK, KS 66210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $5 | $16 | 1.11% |
| VAN SWANSON3 Filed as: VAN SWANSON, INC. | 2272 FRINGE TREE TRAIL THE VILLAGES, FL 32162 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $101K |
| ROBERT E. MILLER INSURANCE AGENCY EIN 43-0902269 BROKER | Other commissions Service code 55 | — | $37K |
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 | 126 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MISSOURI | 336 | $99K |
| Vision | VISION SERVICE PLAN | 96 | $10K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $23K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $34K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $31K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 132 | $372K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 336 | — |
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.