| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | PO BOX 734288 CHICAGO, IL 60673 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| MESIROW INSURANCE SERVICES INC3 | PO BOX 734288 CHICAGO, IL 60673 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| MESIROW INSURANCE SERVICES INC3 | PO BOX 734288 CHICAGO, IL 60673 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| MESIROW INSURANCE SERVICES INC3 | PO BOX 734288 CHICAGO, IL 60673 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD OF KS, INC. | 1133 SOUTH 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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FOUR EVER LIFE INSURANCE CO. | 0 | $1K |
| Dental | BLUE CROSS AND BLUE SHIELD OF KANSAS | 72 | $76K |
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 170 | $7K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 74 | $21K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 74 | $16K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 74 | $17K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF KANSAS | 253 | $382K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 74 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 253 | — |
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."
No prospect flags tripped on this filing.