| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 245 N WACO AVE WICHITA, KS 67202 | DELTA DENTAL OF KANSAS | $3K | — | $3K | 4.74% |
| TERESA BURNETT3 | 1112 E JAMES ST DERBY, KS 67037 | AFLAC | $8K | $304 | $8K | 12.70% |
| JERRY CARROLL GENTRY3 Filed as: JERRY GENTRY | 311 S WALL ST BUHLER, KS 67522 | AFLAC | $1K | $12 | $1K | 2.01% |
| JOHN E WETIG3 Filed as: JOHN WETIG | 103 S ROUPP ST HESSTON, KS 67062 | AFLAC | $1K | $65 | $1K | 1.91% |
| LYNN E MOLLER3 Filed as: LYNN MOLLER | 4527 ENGLISH HOLLY DR FAIRFAX, VA 22030 | AFLAC | $829 | $0 | $829 | 1.27% |
| BRIAN M LEITZEL3 Filed as: BRIAN LEITZEL | 4201 SPRING DR CHENEY, KS 67025 | AFLAC | $371 | $40 | $411 | 0.63% |
| MARC HOMAN3 | 11828 W CENTRAL AVE STE 100 WICHITA, KS 67212 | AFLAC | $232 | — | $232 | 0.36% |
| CALEB GILMOUR3 | 515 S MAIN ST STE 105 WICHITA, KS 67202 | AFLAC | $197 | $0 | $197 | 0.30% |
| MARK ALAN BRYANT3 Filed as: MARK BRYANT | 7920 W KELLOGG DR STE 105 WICHITA, KS 67029 | AFLAC | $158 | $0 | $158 | 0.24% |
| RUSTY J HELIN3 Filed as: RUSTY HELIN | 2012 SE 9TH ST MOORE, OK 73160 | AFLAC | $137 | — | $137 | 0.21% |
| WILLINGHAM INC3 | 35354 MISSOURI BELLEVIEW RD LOUISBURG, KS 66053 | AFLAC | $101 | — | $101 | 0.15% |
| BRANDON UNREIN3 | 15275 SW INDIANOLA RD AUGUSTA, KS 67010 | AFLAC | $84 | — | $84 | 0.13% |
| ASHLE BURNETT3 | 1112 E JAMES ST DERBY, KS 67037 | AFLAC | $80 | — | $80 | 0.12% |
| MITHCHELL K HANEY & ASSOC INC.3 | 701 MCKLINEY ST GREAT BEND, KS 67530 | AFLAC | $64 | — | $64 | 0.10% |
| REBECCA S MOLLER3 Filed as: REBECCA MOLLER | PO BOX 463 ASHLAND, KS 67831 | AFLAC | $63 | — | $63 | 0.10% |
| MADONNA L HASKINS3 Filed as: MADONNA HASKINS | 16376 W 168TH CT OLATHE, KS 66062 | AFLAC | $57 | — | $57 | 0.09% |
| JUSTIN C CARSON3 Filed as: JUSTIN CARSON | 7701 E KELLOGG DR STE 680 WICHITA, KS 67207 | AFLAC | $52 | — | $52 | 0.08% |
| BRAD SCHUMACHER3 | 2804 COUNTRY LN HAYS, KS 67601 | AFLAC | $48 | — | $48 | 0.07% |
| PATRICIA ZOELLER3 | 1825 N COUNTRY CLUB LN KINGMAN, KS 67068 | AFLAC | $47 | — | $47 | 0.07% |
| JOHN C MAGNUSON3 Filed as: JOHN MAGNUSON | 507 S CORONADO AVE LINDSBORG, KS 67456 | AFLAC | $41 | — | $41 | 0.06% |
| MORGAN J KONRADE3 Filed as: MORGAN KONRADE | PO BOX 342 SPEARVILLE, KS 67876 | AFLAC | $41 | — | $41 | 0.06% |
| GARY WILLINGHAM3 | 6033 STRAFFORD OAKS DR SEBRING, FL 33875 | AFLAC | $36 | — | $36 | 0.06% |
| MATTHEW GANT3 | 2501 W 18TH AVE STE A EMPORIA, KS 66801 | AFLAC | $35 | — | $35 | 0.05% |
| GINGER D YOUNG3 Filed as: GINGER YOUNG | 8233 W MEADOW PASS WICHITA, KS 67205 | AFLAC | $30 | — | $30 | 0.05% |
| NATHAN HARRISON3 | 5301 E VISTA RICA ST PARADISE VALLEY, AZ 85253 | AFLAC | $29 | — | $29 | 0.04% |
| KATHY WIEDEMANN3 | 222 HIGH VIEW DR BOULDER, CO 80304 | AFLAC | $26 | — | $26 | 0.04% |
| LEIGH ANNE SEEMAN3 | 1211 W 7TH ST LARNED, KS 67550 | AFLAC | $21 | — | $21 | 0.03% |
| DAN STECKLEIN3 | 2011 CENTRAL AVE LOWER LEVEL SOUTH DODGE CITY, KS 67801 | AFLAC | $20 | — | $20 | 0.03% |
| ALICE JAYLENE CHREST3 Filed as: ALICE CHREST | 88 NE 25 RD GREAT BEND, KS 67530 | AFLAC | $19 | — | $19 | 0.03% |
| CALL INSURANCE SERV INC3 | PO BOX 1090 GREAT BEND, KS 67530 | AFLAC | $18 | — | $18 | 0.03% |
| GARY GIARRATANO3 | 13309 W 73RD ST SHAWNEE, KS 66216 | AFLAC | $13 | — | $13 | 0.02% |
| KENNETH MORRIS JR3 | 5410 PLYMOTH DR LAWRENCE, KS 66049 | AFLAC | $8 | — | $8 | 0.01% |
| TERRY S DECKER3 Filed as: TERRY DECKER | 123401 EW 6 RD TURPIN, OK 73950 | AFLAC | $7 | — | $7 | 0.01% |
| JOHN A BACON3 Filed as: JOHN BACON | 30837 SPRING VALEY RD PAOLA, KS 66071 | AFLAC | $6 | — | $6 | 0.01% |
| BRIAN MILLS3 | 1402 W LUCY WEBB RD RAYMORE, MO 64083 | AFLAC | $2 | — | $2 | 0.00% |
| SUE TUCKER3 | 9856 US HIGHWAY 29 N CUSSETA, AL 36852 | AFLAC | $1 | — | $1 | 0.00% |
| DAVID NELSON3 | 104 5TH ST MC CUNE, KS 66753 | AFLAC | $1 | — | $1 | 0.00% |
| CHRISTOPHER THOMAS HIPP3 Filed as: CHRISTOPHER HIPP | 1601 MEADOW LN HAYS, KS 67601 | AFLAC | $1 | — | $1 | 0.00% |
| USI INSURANCE SERVICES LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | ADVANCE INSURANCE COMPANY OF KANSAS | $2K | — | $2K | 14.55% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHEILD OF KANSAS EIN 48-0952857 SERVICE PROVIDER | Contract Administrator Service code 13 | 1133 SW TOPEKA BOULEVARD TOPEKA, KS 66629 | $122K |
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 | 185 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 185 | 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 | 169 | $431K |
| Dental | DELTA DENTAL OF KANSAS | 157 | $69K |
| Life insurance | ADVANCE INSURANCE COMPANY OF KANSAS | 185 | $16K |
| Long-term disability | AFLAC | 112 | $65K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 169 | $366K |
| Other(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 185 | $382K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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.