| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TERESA BURNETT | 1112 E JAMES ST DERBY, KS 67037 | AFLAC | $4K | $120 | $4K | 8.02% |
| LYNN E MOLLER3 | 4527 ENGLISH HOLLY DR FAIRFAX, VT 22030 | AFLAC | $1K | $0 | $1K | 2.12% |
| MARK ALAN BRYANT3 | 9122 W BIRCH LN WICHITA, KS 67212 | AFLAC | $473 | $0 | $473 | 0.89% |
| BRIAN M LEITZEL3 | 7920 W KELLOGG DR STE 102 WICHITA, KS 67209 | AFLAC | $374 | $7 | $381 | 0.71% |
| CALEB GILMOUR3 Filed as: CALEB J CILMOUR | 515 S MAIN ST WICHITA, KS 67202 | AFLAC | $331 | $25 | $356 | 0.67% |
| MARC LUTHER HOMAN3 Filed as: MARC LUTHR HOMAN | 11828 W CENTRAL AVE STE 100 WICHITA, KS 67212 | AFLAC | $348 | $0 | $348 | 0.65% |
| JUSTIN C CARSON3 | 7701 E KELLOGG DR STE 680 WICHITA, KS 67207 | AFLAC | $200 | $0 | $200 | 0.37% |
| BRANDON M UNREIN3 | 15275 SW INDIANOLA RD AUGUSTA, KS 67010 | AFLAC | $176 | $19 | $195 | 0.37% |
| RUSTY J HELIN3 | 125 W 6TH ST COLBY, KS 67701 | AFLAC | $146 | $0 | $146 | 0.27% |
| ASHLE BURNETT3 Filed as: ASHLE BURNET | 1112 E JAMES ST DERBY, KS 67037 | AFLAC | $136 | $7 | $143 | 0.27% |
| WILLINGHAM INC3 | 35354 MISSION BELLEVIEW RD LOUISBURG, KS 66053 | AFLAC | $129 | $0 | $129 | 0.24% |
| KATHY WIEDEMANN3 | 222 HIGH VIEW DR BOULDER, CO 80304 | AFLAC | $116 | $0 | $116 | 0.22% |
| BRAD SCHUMACHER3 | 2804 COUNTRY LN HAYS, KS 67061 | AFLAC | $100 | $0 | $100 | 0.19% |
| REBECCA S MOLLER3 Filed as: REBECCA MOLLER | PO BOX 463 ASHLAND, KS 67831 | AFLAC | $68 | $0 | $68 | 0.13% |
| PATRICIA ZOELLER3 | PO BOX 81 KINGMAN, KS 67068 | AFLAC | $66 | $0 | $66 | 0.12% |
| JOHN C MAGNUSON3 | 507 S CORONADO AVE LINSBORG, KS 67456 | AFLAC | $65 | $0 | $65 | 0.12% |
| MITHCELL K HANEY & ASSOC INC3 | 702 MCKINLEY ST GREAT BEND, KS 67530 | AFLAC | $64 | $0 | $64 | 0.12% |
| GARY WAYNE WILLINGHAM3 | 6033 STRAFFORD OAKS DR SEBRING, FL 33875 | AFLAC | $61 | $0 | $61 | 0.11% |
| DAN STECKLEIN3 | 2011 CENTRAL AVE LOWER LEVEL SOUTH DODGE CITY, KS 67801 | AFLAC | $56 | $0 | $56 | 0.10% |
| GINGER D YOUNG3 Filed as: GINGER YOUNG | 8233 W MEADOW PASS WICHITA, KS 67205 | AFLAC | $49 | $0 | $49 | 0.09% |
| NATHAN L HARRISON3 | 2 CITYPLACE DR STE 30 CREVE COEUR, MO 63141 | AFLAC | $48 | $0 | $48 | 0.09% |
| GARY GIARRATANO3 Filed as: GARY CIARRATANO | 13309 W 73RD ST SHAWNEE, KS 66216 | AFLAC | $35 | $0 | $35 | 0.07% |
| RUSTY J HELIN3 | 2012 SE 9TH ST MOORE, OK 73160 | AFLAC | $29 | $0 | $29 | 0.05% |
| ALICE JAYLENE CHREST3 | 88 NE 25 RD GREAT BEND, KS 67530 | AFLAC | $24 | $0 | $24 | 0.04% |
| MADONNA L HASKINS3 | PO BOX 1376 DODGE CITY, KS 67801 | AFLAC | $19 | $0 | $19 | 0.04% |
| KENNETH D MORRIS JR3 | 5410 PLYMOUTH DR LAWRENCE, KS 66049 | AFLAC | $18 | $0 | $18 | 0.03% |
| CALL INSURANCE SERV INC3 | PO BOX 1090 GREAT BEND, KS 67530 | AFLAC | $18 | $0 | $18 | 0.03% |
| LEIGH ANNE SEEMAN3 | PO BOX 418 LARNED, KS 67550 | AFLAC | $13 | $0 | $13 | 0.02% |
| IRA A CAPE3 | 2304 FRANKLIN ST GREAT BEND, KS 67530 | AFLAC | $11 | $0 | $11 | 0.02% |
| JOHN A BACON3 Filed as: JOHN BACON | 30837 SPRING VALLEY RD PAOLA, KS 66071 | AFLAC | $10 | $0 | $10 | 0.02% |
| SHAWN D SCHWARZ3 | 1010 DOWNING AVE STE 20 HAYS, KS 67601 | AFLAC | $10 | $0 | $10 | 0.02% |
| DOUGLAS R SCHENKEL3 | 2205 WASHINGTON ST GREAT BEND, KS 67530 | AFLAC | $10 | $0 | $10 | 0.02% |
| TERRY S DECKER3 | RR 2 BOX 22 TURPIN, OK 73950 | AFLAC | $7 | $0 | $7 | 0.01% |
| CHRISTOPHER THOMAS HIPP3 | 1601 MEDOW LN HAYS, KS 67601 | AFLAC | $6 | $0 | $6 | 0.01% |
| BRIAN MILLS3 | 1402 W LUCY WEBB RD RAYMORE, MO 64083 | AFLAC | $3 | $0 | $3 | 0.01% |
| SUE C TUCKER3 | 9856 US HIGHWAY 29 N CUSSETA, AL 36852 | 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 | $987K |
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 | 193 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 193 | 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 | 170 | $430K |
| Dental | DELTA DENTAL OF KANSAS, INC. | 146 | $65K |
| Life insurance | ADVANCE INSURANCE COMPANY OF KANSAS | 193 | $16K |
| Long-term disability | AFLAC | 92 | $53K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF KANSAS | 170 | $376K |
| Other(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF KANSAS | 193 | $392K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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.