| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | BLUE CROSS AND BLUE SHIELD OF KANSAS | $52K | $0 | $52K | 3.00% |
| BRIAN M LEITZEL3 Filed as: BRIAN M. LEITZEL | 4201 SPRING DRIVE CHENEY, KS 67025 | AFLAC | $14K | $242 | $14K | 12.28% |
| JERRY CARROLL GENTRY3 Filed as: JERRY C. GENTRY AND OTHER AGENTS | 311 SOUTH WALL STREET BUHLER, KS 67522 | AFLAC | $2K | $0 | $2K | 1.98% |
| JOHN E WETIG3 Filed as: JOHN E. WETIG | 103 SOUTH ROUPP STREET HESSTON, KS 67062 | AFLAC | $2K | $44 | $2K | 1.88% |
| ROBERT ROWE3 Filed as: ROBERT W. ROWE | 2901 NORTH VAN BUREN STREET HUTCHINSON, KS 67502 | AFLAC | $861 | $0 | $861 | 0.76% |
| MARK ALAN BRYANT3 | 7920 WEST KELLOGG DRIVE, SUITE 105 WICHITA, KS 67209 | AFLAC | $606 | $0 | $606 | 0.53% |
| CALEB GILMOUR3 Filed as: CALEB J. GILMOUR | 515 SOUTH MAIN STREET, SUITE 105 WICHITA, KS 67202 | AFLAC | $473 | $0 | $473 | 0.42% |
| PAUL J SHAEFER3 Filed as: PAUL J. SHAEFER | 1609 SOUTH DOWELL TERRACE WICHITA, KS 67207 | AFLAC | $416 | $0 | $416 | 0.37% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 412 WICHITA, KS 67202 | SURENCY LIFE AND HEALTH | $3K | $0 | $3K | 9.96% |
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 | 214 | 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) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 502 | $1.7M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 502 | $1.8M |
| Vision(2 contracts, 2 carriers) | AFLAC | 237 | $144K |
| Life insurance | AFLAC | 163 | $114K |
| Short-term disability | AFLAC | 163 | $114K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 502 | $1.7M |
| Other | AFLAC | 163 | $114K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 502 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.