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| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF KS EIN 48-0952857 NONE | Claims processing; Insurance services; Contract Administrator; Account maintenance fees; Direct payment from the plan Service code 12 | — | $79K |
| PETRICH BENEFIT PLAN SERVICES NONE | Direct payment from the plan; Insurance agents and brokers Service code 22 | MEDOVA HEALTHCARE FINANCIAL GROUP 345 N. RIVERVIEW SUITE 600 WICHITA, KS 67203 | $23K |
| ALLEN, GIBBS, HOULIK, L.C. EIN 48-1032601 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $16K |
| FOULSTON SIEFKIN LLP NONE | Legal; Direct payment from the plan Service code 29 | 1551 N. WATERFRONT PARKWAY, SUITE 1 WICHITA, KS 672064466 | $6K |
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 | 2,564 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,564 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 2,564 | $2.1M |
| Dental | BLUE CROSS AND BLUE SHIELD OF KANSAS | 2,564 | $2.0M |
| Vision | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 28 | $159K |
| Life insurance(2 contracts, 2 carriers) | ADVANCE INSURANCE COMPANY OF KANSAS | 1,220 | $115K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 2,564 | $2.0M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS AND BLUE SHIELD OF KANSAS | 2,564 | $2.0M |
| Other | ADVANCE INSURANCE COMPANY OF KANSAS | 1,220 | $114K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,564 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.