| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 600 KANSAS CITY, MO 64112 | BLUE CROSS BLUE SHIELD OF KANSAS CITY | $43K | $85K | $128K | 3.06% |
| RONALD N. SELLIN3 | P.O. BOX 2193 PALM SPRINGS, CA 92263 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $22K | — | $22K | 4.01% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS. SERVS. | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $11K | $11K | 2.01% |
| J DEMPSEY INCORPORATED3 Filed as: DEMPSEY INC. | 1304 S. MAIN STREET ANN ARBOR, MI 48106 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $19K | — | $19K | 5.26% |
| THE INSURANCE GROUP3 Filed as: THE INSURANCE GROUP, INC. | 200 SOUTHHAMPTON DRIVE COLUMBIA, MO 65203 | COVENTRY HEALTH AND LIFE | $19K | $720 | $20K | 7.45% |
| BLACK INK SOLUTIONS3 | 480 WEST SUNNYSIDE ROADE, SUITE 4 IDAHO FALLS, ID 83402 | WILLAMETTE DENTAL OF IDAHO, INC. | $1K | $2K | $4K | 19.50% |
| J DEMPSEY INCORPORATED3 Filed as: DEMPSEY INC. | 1304 S. MAIN STREET ANN ARBOR, MI 48104 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $347 | — | $347 | 9.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 ADMINISTRATOR | Contract Administrator Service code 13 | — | $62K |
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 | 531 | 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) | 531 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS BLUE SHIELD OF KANSAS CITY | 987 | $5.4M |
| Dental(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF KANSAS CITY | 987 | $4.6M |
| Vision(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 616 | $407K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 987 | — |
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.