| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS COMPANIES | 920 MAINE ST. KANSAS CITY, MO 64105 | BLUE CROSS AND BLUE SHIELD OF KANSAS | $39K | — | $39K | 1.75% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP OF WICHITA | 7570 W 21ST ST N, STE A, BLDG 1038 WICHITA, KS 67205 | DELTA DENTAL OF KANSAS, INC. | $4K | — | $4K | 2.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - URB | 4565 PAYSHPERE CIR CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $575 | $8K | 18.25% |
| KENNETH DINGWALL INSURANCE3 | 10333 E 21ST ST N, SUITE 403 WICHITA, KS 67206 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $405 | — | $405 | 0.98% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF KANSAS CITY | PO BOX 410249 KANSAS CITY, MO 64141 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 9.21% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH ST. #700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $361 | $361 | 2.00% |
| TERESA BURNETT3 | 1112 E JAMES ST DERBY, KS 67037 | AFLAC | $1K | $71 | $1K | 10.54% |
| FBL INSURANCE BROKERAGE INC3 Filed as: FBL INSURANCE BROKERAGE LLC | 2627 KFB PLZ STE G112 MANHATTAN, KS 66503 | AFLAC | $84 | — | $84 | 0.82% |
| MARC LUTHER HOMAN3 | 11828 W CENTRAL AVE STE 100 WICHITA, KS 67212 | AFLAC | $81 | — | $81 | 0.79% |
| CALEB GILMOUR3 Filed as: CALEB J GILMOUR | 515 S MAIN ST., STE 105 WICHITA, KS 67202 | AFLAC | $69 | $12 | $81 | 0.79% |
| ASHLE BURNETT3 | 1112 E JAMES ST DERBY, KS 67037 | AFLAC | $70 | — | $70 | 0.68% |
| RUSTY J HELIN3 | 125 W 6TH ST COLBY, KS 67701 | AFLAC | $48 | — | $48 | 0.47% |
| WILLINGHAM INC3 Filed as: WILLINGHAM INC. | 1502 N METCALF LOUISBURG, KS 66053 | AFLAC | $48 | — | $48 | 0.47% |
| JUSTIN C CARSON3 | 7701 E KELLOGG DR STE 680 WICHITA, KS 67207 | AFLAC | $40 | — | $40 | 0.39% |
| KATHY WIEDEMANN3 | 220 HIGH VIEW DR BOULDER, CO 80304 | AFLAC | $38 | — | $38 | 0.37% |
| SAMUEL A MCFALL3 | 609 N BROADWAY AVE. STE 200 WICHITA, KS 67214 | AFLAC | $30 | — | $30 | 0.29% |
| INSURANCE INTERMEDIARIES INC3 | 280 N HIGH ST., STE 300 COLUMBUS, OH 43215 | AFLAC | $30 | — | $30 | 0.29% |
| ALAN D HURT3 | PO BOX 277 MOUND CITY, KS 66056 | AFLAC | $25 | — | $25 | 0.24% |
| GARY WAYNE WILLINGHAM3 | 6033 STRAFFORD OAKS DR SEBRING, FL 33875 | AFLAC | $16 | — | $16 | 0.16% |
| BRAD J SCHUMACHER3 | 2804 COUNTRY LN HAYS, KS 67601 | AFLAC | $13 | — | $13 | 0.13% |
| NATHAN L HARRISON3 | 16024 MANCHESTER RD 2ND FLOOR, STE 200 ELLISVILLE, MO 63011 | AFLAC | $5 | — | $5 | 0.05% |
| BRANDON M UNREIN3 | 15275 SW INDIANOLA RD AUGUSTA, KS 67010 | AFLAC | $4 | — | $4 | 0.04% |
| KENNETH D MORRIS JR3 | 5410 PLYMOUTH DR LAWRENCE, KS 66049 | AFLAC | $4 | — | $4 | 0.04% |
| BOMAR DANIEL NOLES JR3 | 200 RIDGEWAY RD LA FAYETTE, GA 30728 | AFLAC | $3 | — | $3 | 0.03% |
| TERRY S DECKER3 | RR 2 BOX 22 TURPIN, OK 73950 | AFLAC | $3 | — | $3 | 0.03% |
| JOHN A BACON3 | 13716 PARKHILL OVERLAND PARK, KS 66221 | AFLAC | $2 | — | $2 | 0.02% |
| JAMES E SHEPARD3 | 11150 GREENWOOD ST., APT 323 LENEXA, KS 66215 | AFLAC | $2 | — | $2 | 0.02% |
| CHRISTOPHER THOMAS HIPP3 | 1601 MEADOW LN HAYS, KS 67601 | AFLAC | $2 | — | $2 | 0.02% |
| BRIAN MILLS3 | 1402 W LUCY WEBB RD RAYMORE, MO 64083 | AFLAC | $1 | — | $1 | 0.01% |
| LYNN E MOLLER3 | 332 E 1ST ST N WICHITA, KS 67202 | AFLAC | $1 | — | $1 | 0.01% |
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 | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 373 | $2.2M |
| Dental | DELTA DENTAL OF KANSAS, INC. | 172 | $134K |
| Vision | VCP SERVICES, INC. | 156 | $16K |
| Life insurance | STANDARD INSURANCE COMPANY | 202 | $60K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 45 | $18K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 201 | $46K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 373 | $2.2M |
| Other(4 contracts, 4 carriers) | STANDARD INSURANCE COMPANY | 210 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 373 | — |
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.