| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | 430 E. DOUGLAS SUITE 400 WICHITA, KS 67202 | BLUE CROSS BLUE SHIELD OF KANSAS | $12K | — | $12K | 3.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF KANSAS EIN 48-0952857 NONE | Other insurance fees and expenses; Trustee (discretionary); Claims processing Service code 12 | 1133 SW TOPEKA BOULEVARD TOPEKA, KS 666290001 | $1.3M |
| TRIA HEALTH, LLC EIN 27-1515235 NONE | Claims processing Service code 12 | 7101 COLLEGE BLVC STE 600 OVERLAND PARK, KS 66210 | $37K |
| LEFEVRE LAW PC EIN 30-0828362 NONE | Insurance agents and brokers Service code 22 | 1302 WAUGH DR. #189 HOUSTON, TX 77019 | $6K |
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 | 1,230 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,240 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD OF KANSAS | 763 | $403K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 763 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.