| 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 | $26K | — | $26K | 3.61% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $29K | $14K | $43K | 22.12% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 412 WICHITA, KS 67202 | DELTA DENTAL OF KANSAS, INC. | $4K | — | $4K | 6.92% |
| RHONDA S PAPE3 Filed as: RHONDA S. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 7.34% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 402 WICHITA, KS 67202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $917 | — | $917 | 5.16% |
| DANE PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $384 | — | $384 | 2.16% |
| DON DOHERTY3 | 710 WEST 8TH STREET, SUITE 206 FORT SCOTT, KS 66701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $331 | — | $331 | 1.86% |
| COLE PAPE3 Filed as: COLE M. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $324 | — | $324 | 1.82% |
| JEREMY BOWMAN3 Filed as: JEREMY LOYAL BOWMAN | 1110 BURKE STREET FORT SCOTT, KS 66701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $115 | — | $115 | 0.65% |
| JESSE A WING3 Filed as: JESSE A. WING | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $95 | — | $95 | 0.53% |
| ROBERT L FLEMINIG3 | 3880 DUE WEST ROAD NW B-2 MARIETTA, GA 30064 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $77 | — | $77 | 0.43% |
| ALAN PAPE3 | 115 E PLATT ST MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $72 | — | $72 | 0.40% |
| GARY MCINTOSH3 Filed as: GARY G MCINTOSH | PO BOX 631 IOLA, KS 66749 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18 | — | $18 | 0.10% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 402 WICHITA, KS 67202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 7.75% |
| RHONDA S PAPE3 Filed as: RHONDA S. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 6.95% |
| COLE PAPE3 Filed as: COLE M. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $410 | — | $410 | 2.71% |
| DANE PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $410 | — | $410 | 2.71% |
| DON DOHERTY3 | 710 WEST 8TH STREET, SUITE 206 FORT SCOTT, KS 66701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $87 | — | $87 | 0.58% |
| JEREMY BOWMAN3 Filed as: JEREMY L. BOWMAN | 1110 BURKE STREET FORT SCOTT, KS 66701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $69 | — | $69 | 0.46% |
| ALAN PAPE3 | 115 E PLATT ST MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $58 | — | $58 | 0.38% |
| GARY MCINTOSH3 Filed as: GARY G MCINTOSH | PO BOX 631 IOLA, KS 66749 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5 | — | $5 | 0.03% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 412 WICHITA, KS 67202 | SURENCY LIFE AND HEALTH | $1K | — | $1K | 10.00% |
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 | 257 | 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) | 257 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 180 | $1.7M |
| Dental(2 contracts, 2 carriers) | KENNION AND COMPANY, LLC | 206 | $147K |
| Vision(2 contracts, 2 carriers) | KENNION AND COMPANY, LLC | 206 | $95K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 257 | $193K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 257 | $193K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 257 | $193K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 180 | $720K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 257 | $226K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.