| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TERESA BURNETT3 Filed as: TERESA L BURNETT | 1112 JAMES ST. DERBY, KS 67037 | AFLAC | $179 | — | $179 | 0.28% |
| JUSTIN C CARSON3 Filed as: JUSTIN CARSON | 7701 E. KELLOGG DR SUITE 680 WICHITA, KS 67207 | AFLAC | $130 | — | $130 | 0.20% |
| KATHY A WIEDEMANN3 | 229 E. WILLIAM #501 WICHITA, KS 67202 | AFLAC | $60 | — | $60 | 0.09% |
| BRAD J SCHUMACHER3 | 2804 COUNTRY LANE HAYS, KS 67601 | AFLAC | $26 | — | $26 | 0.04% |
| BRANDON M UNREIN3 | 15275 SW INDINOLA RD AUGUSTA, KS 67010 | AFLAC | $14 | — | $14 | 0.02% |
| MARK ALAN BRYANT3 Filed as: MARK A BRYANT | 9122 W. BIRCH LN WICHITA, KS 67212 | AFLAC | $14 | — | $14 | 0.02% |
| CALEB GILMOUR3 | 515 S. MAIN SUITE 501 WICHTIA, KS 67202 | AFLAC | $9 | — | $9 | 0.01% |
| CHRISTOPHER THOMAS HIPP3 Filed as: CHRISTOPHER T HIPP | 718 MAIN SUITE 205 HAYS, KS 67601 | AFLAC | $7 | — | $7 | 0.01% |
| BRIAN M LEITZEL3 | 7920 W. KELLOGG DR SUITE 102 WICHITA, KS 67209 | AFLAC | $6 | — | $6 | 0.01% |
| KENNETH D MORRIS JR3 Filed as: KENNETH D MORRIS, JR. | 5410 PLYMOUTH DR LAWRENCE, KS 66049 | AFLAC | $6 | — | $6 | 0.01% |
| 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 | $111K |
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 | 188 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF KANAS | 174 | $424K |
| Dental | DELTA DENTAL, INC | 144 | $63K |
| Life insurance | ADVANCE INSURANCE COMPANY OF KANSAS | 188 | $15K |
| Long-term disability | AFLAC | 86 | $64K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF KANAS | 174 | $361K |
| Other(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF KANAS | 188 | $376K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.