| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 903 EAST 104TH STREET, SUITE 800 KANSAS CITY, MO 64131 | DELTA DENTAL OF KANSAS, INC. | $3K | — | $3K | 2.02% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 903 EAST 104TH STREET, SUITE 800 KANSAS CITY, MO 64131 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 13.00% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $72 | $72 | 0.07% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 903 EAST 104TH STREET, SUITE 800 KANSAS CITY, MO 64131 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 7.38% |
| PETRICH BENEFIT PLAN SERVICES, INC.3 Filed as: PETRICH BENEFIT PLAN SERVICES INC | 345 NORTH RIVERVIEW, SUITE 600 WICHITA, KS 67203 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $975 | — | $975 | 3.13% |
| HARRINGTON BENEFIT SERVICES, INC.3 Filed as: HARRINGTON BENEFIT SERVICES INC | 780 BROOKSEDGE PLAZA DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $843 | — | $843 | 2.70% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 903 EAST 104TH STREET, SUITE 800 KANSAS CITY, MO 64131 | SURENCY LIFE AND HEALTH | $3K | — | $3K | 10.00% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 903 EAST 104TH STREET, SUITE 800 KANSAS CITY, MO 64131 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $1K | $6K | 21.59% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 903 EAST 104TH STREET, SUITE 800 KANSAS CITY, MO 64131 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $41K |
| ROBERT E. MILLER INSURANCE AGENCY BROKER | Insurance agents and brokers Service code 22 | 903 E. 104TH STREET, 800 816-308-4538 KANSAS CITY, MO 64131 | $697 |
| ALLEN, GIBBS & HOULIK, LC EIN 48-1032601 AUDITOR | Accounting (including auditing) Service code 10 | — | $0 |
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 | 219 | 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) | 219 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KANSAS, INC. | 189 | $143K |
| Vision | SURENCY LIFE AND HEALTH | 151 | $31K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 633 | $135K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 314 | $30K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 314 | $30K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 219 | $280K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 633 | $160K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 633 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.