| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL KELLER3 | 4622 PENNSYLVANIA AVENUE SUITE 920 KANSAS CITY, MO 64112 | BLUE CROSS AND BLUE SHIELD OF KANSAS | $13K | — | $13K | 1.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS-WICHITA | 10333 E 21ST ST NORTH SUITE 104 WICHITA, KS 67206 | DELTA DENTAL OF KANSAS, INC. | $3K | — | $3K | 5.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10333 EAST 21ST STREET NORTH SUITE 104 WICHITA, KS 672063544 | ADVANCE INSURANCE COMPANY OF KANSAS | $2K | — | $2K | 8.50% |
| IMA, INC.3 Filed as: IMA INC | 11350 SWITZER ROAD #200 OVERLAND PARK, KS 66210 | ADVANCE INSURANCE COMPANY OF KANSAS | $1K | — | $1K | 5.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 10333 E 21ST ST N STE 104 WICHITA, KS 67206 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.62% |
| IMA, INC.3 Filed as: IMA INC | 8200 E 32ND STREET NORTH WICHITA, KS 67226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 7.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 S STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.98% |
| TERESA BURNETT3 | 1112 E JAMES ST DERBY, KS 67037 | AFLAC | $705 | $122 | $827 | 5.66% |
| MARK ALAN BRYANT3 Filed as: MARK BRYANT | 7920 W KELLOGG DR STE 105 WICHITA, KS 67209 | AFLAC | $270 | — | $270 | 1.85% |
| JOHN E WETIG3 Filed as: JOHN WETIG | 103 S ROUPP ST HESSTON, KS 67062 | AFLAC | $144 | $26 | $170 | 1.16% |
| JERRY CARROLL GENTRY3 Filed as: JERRY GENTRY | 311 S WALL ST BUHLER, KS 67522 | AFLAC | $143 | $26 | $169 | 1.16% |
| LYNN E MOLLER3 Filed as: LYNN MOLLER | 4527 ENGLISH HOLLY DR FAIRFAX, VA 22030 | AFLAC | $104 | — | $104 | 0.71% |
| MARY TEICHGRAEBER3 | 931 167TH ST EUREKA, KS 67045 | AFLAC | $62 | — | $62 | 0.42% |
| RACHEL SHAEFER3 | 529 PARKWOOD DR ROSE HILL, KS 67133 | AFLAC | $61 | — | $61 | 0.42% |
| MARC HOMAN3 | 11828 W CENTRAL AVE STE 100 WICHITA, KS 67212 | AFLAC | $50 | — | $50 | 0.34% |
| PATRICIA ZOELLER3 | 1825 N COUNTRY CLUB LN KINGMAN, KS 67068 | AFLAC | $38 | — | $38 | 0.26% |
| NATHAN HARRISON3 | 5301 E VISTA RICA ST PARADISE VALLEY, AZ 85253 | AFLAC | $38 | — | $38 | 0.26% |
| WILLIAM K TEICHGRAEBER3 Filed as: WILLIAM TEICHGRAEBER | 931 167TH ST EUREKA, KS 67045 | AFLAC | $34 | — | $34 | 0.23% |
| ASHLE BURNETT3 | 1112 E JAMES ST DERBY, KS 67037 | AFLAC | $23 | — | $23 | 0.16% |
| PAUL J SHAEFER3 Filed as: PAUL SHAEFER | 529 PARKWOOD DR ROSE HILL, KS 67133 | AFLAC | $22 | — | $22 | 0.15% |
| KATHY WIEDEMANN3 | 222 HIGH VIEW DR BOULDER, CO 80304 | AFLAC | $21 | — | $21 | 0.14% |
| SAMUEL A MCFALL3 Filed as: SAMUEL MCFALL | 609 N BROADWAY AVE STE 200 WICHITA, KS 67214 | AFLAC | $18 | — | $18 | 0.12% |
| SCOTT W LUTY3 Filed as: SCOTT LUTY | 524 E 30TH AVE HUTCHINSON, KS 67502 | AFLAC | $12 | — | $12 | 0.08% |
| WILLINGHAM INC3 | 35354 MISSION BELLEVIEW RD LOUISBURG, KS 66053 | AFLAC | $11 | — | $11 | 0.08% |
| GARY GIARRATANO3 | 13309 W 73RD ST SHAWNEE, KS 66216 | AFLAC | $8 | — | $8 | 0.05% |
| BRIAN M LEITZEL3 Filed as: BRIAN LEITZEL | 4201 SPRING DR CHENEY, KS 67025 | AFLAC | $6 | — | $6 | 0.04% |
| BRAD SCHUMACHER3 | 2804 COUNTRY LN HAYS, KS 67601 | AFLAC | $5 | — | $5 | 0.03% |
| KENNETH MORRIS JR3 | 5410 PLYMOUTH DR LAWRENCE, KS 66049 | AFLAC | $3 | — | $3 | 0.02% |
| SUE TUCKER3 | 9856 US HIGHWAY 29 N CUSSETA, AL 36852 | AFLAC | $3 | — | $3 | 0.02% |
| JOHN A BACON3 Filed as: JOHN BACON | 1100 AUTUMN CIR UNIT 4 LOUISBURG, KS 66053 | AFLAC | $3 | — | $3 | 0.02% |
| TERRY S DECKER3 Filed as: TERRY DECKER | 123401 EW 6 RD TURPIN, OK 73950 | AFLAC | $2 | — | $2 | 0.01% |
| IMA, INC.3 Filed as: IMA INC | 11350 SWITZER RD #200 OVERLAND PARK, KS 66210 | 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 | 140 | 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) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 173 | $813K |
| Dental(2 contracts) | DELTA DENTAL OF KANSAS, INC. | 120 | $49K |
| Vision | SURENCY LIFE AND HEALTH | 79 | $13K |
| Life insurance(2 contracts, 2 carriers) | ADVANCE INSURANCE COMPANY OF KANSAS | 140 | $41K |
| Short-term disability | ADVANCE INSURANCE COMPANY OF KANSAS | 140 | $21K |
| Long-term disability | ADVANCE INSURANCE COMPANY OF KANSAS | 140 | $21K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 173 | $813K |
| Other(3 contracts, 3 carriers) | ADVANCE INSURANCE COMPANY OF KANSAS | 140 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.