| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERHAB5 Filed as: INTERHAB, INC. | 1619 N WATERFRONT PKWY WICHITA, KS 672789769 | DELTA DENTAL OF KANSAS, INC. | $2K | $0 | $2K | 3.50% |
| TERESA BURNETT3 | 1112 E JAMES ST DERBY, KS 67037 | AFLAC | $3K | $126 | $3K | 6.53% |
| LYNN E MOLLER3 | 332 E 1ST ST N WICHITA, KS 67202 | AFLAC | $2K | $0 | $2K | 3.63% |
| JUSTIN C CARSON3 | 7701 E KELLOGG STE 680 WICHITA, KS 67207 | AFLAC | $610 | $28 | $638 | 1.38% |
| ASHLE BURNETT3 | 1112 E JAMES ST DERBY, KS 67037 | AFLAC | $478 | $47 | $525 | 1.13% |
| KATHY WIEDEMANN3 | 229 E WILLIAM ST STE 501 WICHITA, KS 67202 | AFLAC | $456 | $35 | $491 | 1.06% |
| MARC LUTHER HOMAN3 | 11828 W CENTRAL AVE STE 100 WICHITA, KS 67212 | AFLAC | $420 | $0 | $420 | 0.91% |
| BRAD J SCHUMACHER3 | 718 MAIN ST STE 205 HAYS, KS 67601 | AFLAC | $317 | $35 | $352 | 0.76% |
| REBECCA S MOLLER3 | 8918 W MEADOW PARK CT WICHITA, KS 67205 | AFLAC | $240 | $0 | $240 | 0.52% |
| WILLINGHAM INC3 | 1502 NO METCALF LOUISBURG, KS 66053 | AFLAC | $161 | $0 | $161 | 0.35% |
| NATHAN L HARRISON3 | 16024 MANCHESTER RD 2ND FLOOR STE 200 ELLISVILLE, MO 63011 | AFLAC | $97 | $0 | $97 | 0.21% |
| DAN STECKLEIN3 | 2011 CENTRAL AVE LOWER LEVEL SOUTH DODGE CITY, KS 67801 | AFLAC | $64 | $0 | $64 | 0.14% |
| GARY WAYNE WILLINGHAM3 | 8116 STATE RD 66 ZOLFO SPRINGS, FL 33890 | AFLAC | $60 | $0 | $60 | 0.13% |
| MITCHELL K HANEY & ASSOC INC3 | 701 MCKINLEY ST GREAT BEND, KS 67530 | AFLAC | $53 | $0 | $53 | 0.11% |
| GINGER D YOUNG3 | 8233 W MEADOW PASS WICHITA, KS 67205 | AFLAC | $52 | $0 | $52 | 0.11% |
| GARY GIARRATANO3 | 8612 SHADY BEND RD LENEXA, KS 66227 | AFLAC | $50 | $0 | $50 | 0.11% |
| JOHN C MAGNUSON3 | PO BOX 8 LINDSBORG, KS 67456 | AFLAC | $48 | $0 | $48 | 0.10% |
| DOUGLAS R SCHENKEL3 | PO BOX 1842 GREAT BEND, KS 67530 | AFLAC | $39 | $0 | $39 | 0.08% |
| MADONNA L HASKINS3 | 1712 CENTRAL AVE DODGE CITY, KS 67801 | AFLAC | $32 | $0 | $32 | 0.07% |
| KALA E MARIS3 | PO BOX 643 ASHLAND, KS 67831 | AFLAC | $20 | $0 | $20 | 0.04% |
| CALL INSURANCE SERV INC3 Filed as: CALL INSURANCE SERVICE INC | PO BOX 1090 GREAT BEND, KS 67530 | AFLAC | $15 | $0 | $15 | 0.03% |
| JAMES BRIEL3 | 400 HAZEL AVE WAKEENEY, KS 67672 | AFLAC | $15 | $0 | $15 | 0.03% |
| INSURANCE PROFESSIONALS OF KS INC3 Filed as: INSURANCE PROFESSIONALS OF KANSAS | 8414 W 13TH ST N STE 190 WICHITA, KS 67212 | AFLAC | $15 | $0 | $15 | 0.03% |
| SCOTT W LUTY3 | 524 E 30TH AVE HUTCHINSON, KS 67502 | AFLAC | $9 | $0 | $9 | 0.02% |
| IRA A CAPE3 | 1411 18TH ST GREAT BEND, KS 67530 | AFLAC | $8 | $0 | $8 | 0.02% |
| SHAWN D SCHWARZ3 | 1010 DOWNING AVE STE 20 HAYS, KS 67601 | AFLAC | $8 | $0 | $8 | 0.02% |
| ALIDA S CASPER3 | 113 GREENBRIAR CIRCLE MANNFORD, OK 74044 | AFLAC | $6 | $0 | $6 | 0.01% |
| TOM EDWARD TURLEY3 | 4705 SPRING RIDGE RD ENID, OK 73703 | AFLAC | $6 | $0 | $6 | 0.01% |
| LESLIE B BERGSTROM3 | PO BOX 435 PLAINS, KS 67869 | AFLAC | $4 | $0 | $4 | 0.01% |
| FLORENCE MARIE HEFT3 | PO BOX 731 COLDWATER, KS 67029 | AFLAC | $2 | $0 | $2 | 0.00% |
| LON E PISHNY3 | 1521 E FULTON TERRACE GARDEN CITY, KS 67846 | AFLAC | $2 | $0 | $2 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF KANSAS EIN 48-0952857 SERVICE PROVIDER | Contract Administrator Service code 13 | 1133 SW TOPEKA BLVD TOPEKA, KS 66629 | $113K |
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 | 171 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF KANSAS | 154 | $1.0M |
| Dental | DELTA DENTAL OF KANSAS, INC. | 133 | $53K |
| Life insurance | ADVANCE INSURANCE COMPANY OF KANSAS | 172 | $14K |
| Long-term disability | AFLAC | 87 | $46K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF KANSAS | 154 | $998K |
| Other | ADVANCE INSURANCE COMPANY OF KANSAS | 172 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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 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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.