| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FEE INSURANCE GROUP3 | 2920 N PLUM ST HUTCHINSON, KS 67502 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| FEE INSURANCE GROUP3 | 2920 N PLUM ST HUTCHINSON, KS 67502 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| FEE INSURANCE GROUP3 | 2920 N PLUM ST HUTCHINSON, KS 67502 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| FEE INSURANCE GROUP3 | 2920 N. PLUM ST. HUTCHINSON, KS 67502 | VISION SERVICE PLAN | $768 | — | $768 | 7.35% |
| FEE INSURANCE GROUP3 | 2920 N PLUM ST HUTCHINSON, KS 67502 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $975 | — | $975 | 10.00% |
| TERESA BURNETT3 | 1112 E JAMES ST DERBY, KS 67037 | AFLAC | $149 | — | $149 | 7.29% |
| LAURENCE W KEMP3 Filed as: LAURENCE KEMP | 1018 N BATTIN ST WICHITA, KS 67208 | AFLAC | $72 | — | $72 | 3.52% |
| MARC LUTHER HOMAN3 | 11828 W CENTRAL AVE WICHITA, KS 67212 | AFLAC | $40 | — | $40 | 1.96% |
| NATHAN HARRISON3 | 5301 E VISTA RICA ST PARADISE VALLEY, AZ 85253 | AFLAC | $18 | — | $18 | 0.88% |
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 | 101 | 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) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 176 | $0 |
| Dental | BLUE CROSS AND BLUE SHIELD OF KANSAS | 176 | $0 |
| Vision | VISION SERVICE PLAN | 74 | $10K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 101 | $37K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 43 | $10K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 26 | $11K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 176 | $0 |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 101 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.