| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VARIOUS3 | PO BOX 1365 COLUMBIA, SC 292021365 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $56 | $1K | 3.50% |
| NORTHWEST ENROLLX LLC3 | 7656 TWP RD. 94 FINDLAY, OH 45840 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $20 | $1K | 3.43% |
| NORTHWEST WORKSITE MARKETING CORP3 | 1910 INDIAN WOOD CT MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 2.76% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $2K | $5K | 14.71% |
| USI INSURANCE SERVICES LLC3 | 245 N WACO, SUITE 412 WICHITA, KS 67202 | VCP SERVICES, INC. | $1K | — | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF KANSAS EIN 48-0952857 NONE | Claims processing Service code 12 | 1133 SW TOPEKA BOULEVARD TOPEKA, KS 666290001 | $108K |
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VCP SERVICES, INC. | 97 | $15K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 130 | $45K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 128 | $36K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 128 | $36K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF KANSAS | 251 | $269K |
| Other | ADVANCE INSURANCE COMPANY OF KANSAS | 130 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 251 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.