| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | BLUE CROSS BLUE SHIELD OF KANSAS | $17K | $0 | $17K | 3.83% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $25K | $11K | $37K | 21.60% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 412 WICHITA, KS 67202 | DELTA DENTAL OF KANSAS, INC. | $3K | $0 | $3K | 5.12% |
| RHONDA S PAPE3 Filed as: RHONDA S. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.57% |
| DON DOHERTY3 | 710 WEST 8TH STREET, SUITE 206 FORT SCOTT, KS 66701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $475 | $0 | $475 | 2.63% |
| COLE PAPE3 Filed as: COLE PAPE AND OTHER AGENTS | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $337 | $15 | $352 | 1.95% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 402 WICHITA, KS 67202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $284 | $0 | $284 | 1.57% |
| DANE PAPE3 | 115 EAST PLATT STREET MAQUIKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $183 | $0 | $183 | 1.01% |
| JEREMY BOWMAN3 Filed as: JEREMY L. BOWMAN | 1110 BURKE STREET FORT SCOTT, KS 66701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $167 | $0 | $167 | 0.92% |
| JESSE A WING3 Filed as: JESSE A. WING | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $139 | $0 | $139 | 0.77% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 402 WICHITA, KS 67202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 6.90% |
| RHONDA S PAPE3 Filed as: RHONDA S. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $893 | $0 | $893 | 5.29% |
| COLE PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $404 | $0 | $404 | 2.40% |
| DANE PAPE3 | 115 EAST PLATT STREET MAQUIKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $402 | $0 | $402 | 2.38% |
| RHONDA S PAPE3 Filed as: RHONDA PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $180 | $0 | $180 | 1.07% |
| JEREMY BOWMAN3 Filed as: JEREMY L. BOWMAN AND OTHER AGENTS | 1110 BURKE STREET FORT SCOTT, KS 66701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $121 | $50 | $171 | 1.01% |
| DON DOHERTY3 | 710 WEST 8TH STREET, SUITE 206 FORT SCOTT, KS 66701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $95 | $0 | $95 | 0.56% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 412 WICHITA, KS 67202 | SURENCY LIFE AND HEALTH | $855 | $0 | $855 | 9.86% |
No Schedule C service providers reported on this filing.
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 | 210 | 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) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF KANSAS | 110 | $441K |
| Dental(2 contracts, 2 carriers) | KENNION AND COMPANY, LLC | 172 | $136K |
| Vision(2 contracts, 2 carriers) | KENNION AND COMPANY, LLC | 172 | $95K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 208 | $169K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 208 | $169K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 208 | $169K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF KANSAS | 110 | $441K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 208 | $204K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 208 | — |
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.