| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BREACH, VA 23466 | BLUE CROSS AND BLUE SHIELD OF KANSAS | $19K | $0 | $19K | 3.91% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $27K | $14K | $41K | 22.89% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 412 WICHITA, KS 67202 | DELTA DENTAL OF KANSAS, INC. | $3K | $0 | $3K | 5.72% |
| RHONDA S PAPE3 Filed as: RHONDA S. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $958 | $0 | $958 | 5.77% |
| DON DOHERTY3 | 710 WEST 8TH STREET, SUITE 206 FORT SCOTT, KS 66701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $403 | $0 | $403 | 2.43% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 402 WICHITA, KS 67202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $371 | $0 | $371 | 2.23% |
| JESSE A WING3 Filed as: JESSE A. WING AND OTHER AGENTS | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $339 | $4 | $343 | 2.06% |
| DANE PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $202 | $0 | $202 | 1.22% |
| JEREMY BOWMAN3 Filed as: JEREMY LOYAL BOWMAN | 1110 BURKE STREET FORT SCOTT, KS 66701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $141 | $0 | $141 | 0.85% |
| COLE PAPE3 Filed as: COLE M. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $130 | $0 | $130 | 0.78% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 402 WICHITA, KS 67202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $757 | $0 | $757 | 5.01% |
| RHONDA S PAPE3 Filed as: RHONDA S. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $584 | $0 | $584 | 3.87% |
| COLE PAPE3 Filed as: COLE M. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $260 | $0 | $260 | 1.72% |
| DANE PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $260 | $0 | $260 | 1.72% |
| RHONDA S PAPE3 Filed as: RHONDA PAPA | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $178 | $0 | $178 | 1.18% |
| JEREMY BOWMAN3 Filed as: JEREMY L. BOWMAN AND OTHER AGENTS | 1110 BURKE STREET FORT SCOTT, KS 66701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $110 | $16 | $126 | 0.83% |
| DON DOHERTY3 | 710 WEST 8TH STREET, SUITE 206 FORT SCOTT, KS 66701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $95 | $0 | $95 | 0.63% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 412 WICHITA, KS 67202 | SURENCY LIFE AND HEALTH | $995 | $0 | $995 | 10.12% |
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 | 242 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 139 | $477K |
| Dental(2 contracts, 2 carriers) | KENNION AND COMPANY, LLC | 148 | $137K |
| Vision(2 contracts, 2 carriers) | KENNION AND COMPANY, LLC | 148 | $98K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 241 | $181K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 241 | $181K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 241 | $181K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 139 | $477K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 241 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 241 | — |
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.