| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 33 EAST 21ST STREET NORTH SUITE 104 WICHITA, KS 67206 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | $0 | $17K | 13.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 4.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VCP SERVICES, INC. | $5K | $0 | $5K | 10.00% |
| JASON D GROSS3 Filed as: JASON D. GROSS | 511 SOUTH MAIN STREET KENSINGTON, KS 66951 | AFLAC | $2K | $83 | $2K | 6.50% |
| RYAN DAVID WINDHOLZ3 | PO BOX 1225 HAYS, KS 67601 | AFLAC | $983 | $35 | $1K | 3.66% |
| DAVID J WINDHOLZ3 Filed as: DAVID J. WINDHOLZ | PO BOX 1225 HAYS, KS 67601 | AFLAC | $649 | $35 | $684 | 2.46% |
| MICHELE PFANNENSTEIL & OTHER AGENTS3 | 1704 JUDITH DRIVE HAYS, KS 67601 | AFLAC | $452 | $0 | $452 | 1.63% |
| ANTHONY ELDEE CONNER3 | 10373 EAST 37TH PLACE YUMA, AZ 85365 | AFLAC | $338 | $16 | $354 | 1.27% |
| CLINT ANDERSEN3 | PO BOX 586 RUSHVILLE, NE 69360 | AFLAC | $193 | $19 | $212 | 0.76% |
| JORDAN J SHARP3 Filed as: JORDAN J. SHARP | 1473 TOULON AVENUE HAYS, KS 67601 | AFLAC | $158 | $0 | $158 | 0.57% |
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 | 287 | 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) | 287 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | THE VITALITY GROUP, LLC | 4,414 | $54K |
| Vision | VCP SERVICES, INC. | 661 | $49K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 287 | $124K |
| Short-term disability | AFLAC | 25 | $28K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 287 | $124K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF KANSAS | 888 | $1.1M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,414 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,414 | — |
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."
No prospect flags tripped on this filing.