| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET SUITE 1100 CHICAGO, IL 60654 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $696 | $3K | 19.27% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET SUITE 1100 CHICAGO, IA 60654 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $665 | $3K | 19.29% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET SUITE 1100 CHICAGO, IL 60654 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $447 | $2K | 18.73% |
| WENDI HORAK3 | 6321 NORTHWEST HUMPHREY ROAD TOPEKA, KS 66618 | AFLAC | $159 | $191 | $350 | 3.38% |
| MARTHA P BUESS3 Filed as: MARTHA BUESS | 2948 EAST RAY AVENUE SALINA, KS 67401 | AFLAC | $174 | — | $174 | 1.68% |
| MICHAEL YURCZYK3 | 9616 WYOMING TERRACE SOUTH BLOOMINGTON, MN 55438 | AFLAC | $79 | $21 | $100 | 0.97% |
| ROBERT BURNS FAUGHT JR3 Filed as: ROBERT FAUGHT JR | PO BOX 4566 TOPEKA, KS 66604 | AFLAC | $82 | $17 | $99 | 0.96% |
| MELINDA S CURTISS3 Filed as: MELINDA CURTISS | 18654 MORRISS ROAD CONNEAUTVILLE, PA 16406 | AFLAC | $95 | — | $95 | 0.92% |
| JODY HIPP3 | PO BOX 1587 HAYS, KS 67601 | AFLAC | $76 | — | $76 | 0.73% |
| PERRY HENAULT3 | 4323 SOUTHWEST MISTY HARBOR DRIVE TOPEKA, KS 66610 | AFLAC | $44 | $17 | $61 | 0.59% |
| MESIROW INSURANCE SERVICES INC3 | 321 NORTH CLARK STREET CHICAGO, IL 60610 | AFLAC | $59 | — | $59 | 0.57% |
| JONI S WOBORNY BUNKER3 Filed as: JONI WOBORNY BUNKER | 1837 VIRGINIA DRIVE MANHATTAN, KS 66502 | AFLAC | $58 | — | $58 | 0.56% |
| BRAD SCHUMACHER3 | 2804 COUNTRY LANE HAYS, KS 67601 | AFLAC | $48 | — | $48 | 0.46% |
| MARTHA A DUBOIS3 Filed as: MARTHA DUBOIS | 8431 SOUTH 84TH AVENUE HICKORY HILLS, IL 60457 | AFLAC | $47 | — | $47 | 0.45% |
| HUERTA AND ASSOCIATES INC3 Filed as: HUERTA AND ASSOCIATION INC | 9701 SOUTH 78TH AVENUE SUITE 202 HICKORY HILLS, IL 60457 | AFLAC | $44 | — | $44 | 0.43% |
| BILLY M CRAIN3 Filed as: BILLY CRAIN | 1026 RHODES LANE BROOKEVILLE, PA 15825 | AFLAC | $23 | — | $23 | 0.22% |
| VONDA OLDHAM CAPO3 Filed as: VONDA CAPO | 1617 ORCHARD LANE HIDEAWAY, TX 75771 | AFLAC | $22 | — | $22 | 0.21% |
| WILLINGHAM INC3 | 1502 NORTH METCALF LOUISBURG, KS 66053 | AFLAC | $20 | — | $20 | 0.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 14TH FLOOR ARLINGTON HEIGHTS, IL 60006 | AFLAC | $16 | — | $16 | 0.15% |
| OWENMYRTLE INC3 | 1611 ST. ANDREWS DRIVE SUITE 22 LAWRENCE, KS 66047 | AFLAC | $14 | — | $14 | 0.14% |
| MARIO HAIFA3 | 1195 WASHINGTON PIKE SUITE 300 BRIDGEVILLE, PA 15017 | AFLAC | $12 | — | $12 | 0.12% |
| MICHAEL LOWE3 | PO BOX 1746 MANHATTAN, KS 66505 | AFLAC | $10 | — | $10 | 0.10% |
| VICKI L CIGER3 Filed as: VICKI CIGER | 4020 OAK TREE LANE PLAINFIELD, IL 60586 | AFLAC | $9 | — | $9 | 0.09% |
| SHELLY M BAYS3 Filed as: SHELLY BAYS | 4435 ENGLISH LANE LAFAYETTE, IN 47909 | AFLAC | $9 | — | $9 | 0.09% |
| NATHAN HARRISON3 | 16024 MANCHESTER ROAD 2ND FLOOR SUITE 200 ELLISVILLE, MA 63011 | AFLAC | $6 | — | $6 | 0.06% |
| LARRY D DENNY3 Filed as: LARRY MARONEY | 1230 MOUNTAIN BREEZE CANYON LAKE, TX 78133 | AFLAC | $5 | — | $5 | 0.05% |
| BRIAN MILLS3 | PO BOX 527 LAWRENCE, KS 66044 | AFLAC | $5 | — | $5 | 0.05% |
| KRISTY GRAMLICH INC3 | 455 SOUTH SAM BARR DRIVE SUITE 205 KEARNEY, MO 64060 | AFLAC | $4 | — | $4 | 0.04% |
| COURTNEY YURCZYK3 | 9616 WYOMING TERRACE SOUTH MINNEAPOLIS, MN 55438 | AFLAC | $3 | — | $3 | 0.03% |
| TODD DEVOSS3 | 321 NORTH CLARK STREET SUITE 625 CHICAGO, IA 60654 | AFLAC | $3 | — | $3 | 0.03% |
| JOSEPH P CALARCO3 Filed as: JOSEPH NASCA | 28081 WEST MAPLE AVENUE BARRINGTON, IL 60010 | AFLAC | $3 | — | $3 | 0.03% |
| JOY GRUBE PADGELEK3 Filed as: JOY PADGELEK | 1195 WASHINGTON PIKE SUITE 300 BRIDGEVILLE, PA 15017 | AFLAC | $3 | — | $3 | 0.03% |
| BRIAN MILLS3 | 1402 WEST LUCY WEBB ROAD RAYMORE, MO 64083 | AFLAC | $2 | — | $2 | 0.02% |
| TERRY S DECKER3 Filed as: TERRY DECKER | ROUTE 2 BOX 22 TURPIN, OK 73950 | AFLAC | $2 | — | $2 | 0.02% |
| MARK D BARBIER3 Filed as: MARK BARBIER | 802 DEER TRAIL LANE OAK BROOK, IL 60523 | AFLAC | $2 | — | $2 | 0.02% |
| BRIAN W PATTEN3 Filed as: BRIAN PATTEN | 120 MARGUERITE DRIVE SUITE 101 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $1 | — | $1 | 0.01% |
| JAMES BRANDT3 | 47 MARVIN STREET PORT MATILDA, PA 16870 | AFLAC | $1 | — | $1 | 0.01% |
| KENNETH MORRIS JR3 | 5410 PLYMOUTH DRIVE LAWRENCE, KS 66049 | AFLAC | $1 | — | $1 | 0.01% |
| JOHN A BACON3 Filed as: JOHN BACON | 13716 PARKHILL OVERLAND PARK, KS 66221 | AFLAC | $1 | — | $1 | 0.01% |
| JEREMY FRYE & ASSOCIATES INC3 | 1508 NORTH CHURCH ROAD SUITE B LIBERTY, MO 64068 | AFLAC | $1 | — | $1 | 0.01% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET SUITE 1100 CHICAGO, IL 60654 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $408 | $2K | 19.23% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD OF KS, INC. | 1133 SOUTHWEST TOPEKA BOULEVARD TOPEKA, KS 66629 | FOUR EVER LIFE INSURANCE CO | — | $162 | $162 | 14.96% |
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 | 148 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS AND BLUESHIELD OF KANSAS | 323 | $1.8M |
| Dental | BLUECROSS AND BLUESHIELD OF KANSAS | 323 | $1.8M |
| Vision | EYEMED VISION CARE | 186 | $9K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 89 | $22K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 89 | $16K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 89 | $16K |
| Prescription drug | BLUECROSS AND BLUESHIELD OF KANSAS | 323 | $1.8M |
| Other(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 89 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 323 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.