| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: HOMETOWN AGENCY AND VARIOUS AGENTS | PO BOX 507 CAMBRIDGE, NE 69022 | AFLAC | $4K | $9 | $4K | 3.08% |
| CHERYL MAUS3 | PO BOX 236 LEBANON, KS 66952 | AFLAC | $3K | $152 | $3K | 2.58% |
| JODY HIPP3 | PO BOX 1587 HAYS, KS 67601 | AFLAC | $3K | $55 | $3K | 2.26% |
| RANDY MAUS3 | PO BOX 236 LEBANON, KS 66952 | AFLAC | $2K | $55 | $2K | 1.43% |
| DAVID J WINDHOLZ3 Filed as: DAVID WINDHOLZ | 102 WEST 15TH STREET HAYS, KS 67601 | AFLAC | $2K | $52 | $2K | 1.35% |
| MARK FRIEHE3 | 4611 SOUTH 96TH STREET, SUITE 101 OMAHA, NE 68127 | AFLAC | $1K | — | $1K | 0.85% |
| BRAD SCHUMACHER3 | 718 MAIN STREET, SUITE 205 HAYS, KS 67601 | AFLAC | $928 | — | $928 | 0.78% |
| TIG ADVISORS3 Filed as: TIG, LLC | 416 STATE STREET AUGUSTA, KS 67010 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | — | $8K | 9.09% |
| PRIOR AGENCY3 | UNKNOWN WICHITA, KS 67208 | DELTA DENTAL OF KANSAS, INC. | $1K | — | $1K | 1.89% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, INC. | 245 NORTH WACO, SUITE 412 WICHITA, KS 67202 | DELTA DENTAL OF KANSAS, INC. | $746 | — | $746 | 1.00% |
| TIG ADVISORS3 Filed as: TIG LLC | 416 STATE STREET AUGUSTA, KS 67010 | THE LINCOLN NATIONAL LIFE INSURANCE COMAPNY | $5K | — | $5K | 7.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMAPNY | $878 | — | $878 | 1.26% |
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 |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | AFLAC | 153 | $193K |
| Vision | AFLAC | 153 | $118K |
| Life insurance(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 161 | $159K |
| Short-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 161 | $153K |
| Long-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 161 | $153K |
| Other(4 contracts, 4 carriers) | AFLAC | 161 | $277K |
| 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."
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.