| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $0 | $13K | 15.00% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO STREET, SUITE 402 WICHITA, KS 67202 | VISION SERVICE PLAN | $873 | $0 | $873 | 5.95% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $43 | $0 | $43 | 0.29% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 402 WICHITA, KS 67202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.51% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $331 | $0 | $331 | 3.30% |
| HARRINGTON BENEFIT SERVICES, INC.3 | 780 BROOKSEDGE PLAZA DRIVE WESTERVILLE, OH 43081 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $228 | $0 | $228 | 2.27% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 412 WICHITA, KS 67202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.02% |
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 | 161 | 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) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 161 | $836K |
| Dental | DELTA DENTAL OF KANSAS, INC. | 102 | $70K |
| Vision | VISION SERVICE PLAN | 88 | $15K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 161 | $84K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 161 | $84K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 161 | $84K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 161 | $836K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 161 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.