| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFITS SERVICES INC | 2345 GRAND BLVD SUITE 900 KANSAS CITY, MO 64108 | COVENTRY HEALTH CARE OF KANSAS INC | $19K | — | $19K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 2345 GRAND BLVD SUITE 900 KANSAS CITY, MO 64108 | COVENTRY HEALTH AND LIFE | $7K | $4K | $10K | 4.53% |
| DELTA DENTAL OF KANSAS3 Filed as: DELTA DENTAL OF KANSAS INC | 1619 N WATERFRONT PARKWAY WICHITA, KS 67278 | DELTA DENTAL OF KANSAS INC | $5K | — | $5K | 6.96% |
| SURRENCY LIFE AND HEALTH | 1619 N WATERFRONT PARKWAY WICHITA, KS 67278 | SURRENCY LIFE AND HEALTH | $443 | — | $443 | 9.88% |
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 | 86 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 86 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COVENTRY HEALTH CARE OF KANSAS INC | 151 | $875K |
| Dental | DELTA DENTAL OF KANSAS INC | 94 | $65K |
| Vision | SURRENCY LIFE AND HEALTH | 30 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.