| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2345 GRAND BLVD, SUITE 400 KANSAS CITY, MO 641082625 | BLUE CROSS AND BLUE SHIELD OF KANSAS | $27K | — | $27K | 3.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE - WICHITA | 8100 E 32ND ST N STE 100 WICHITA, KS 67226 | DELTA DENTAL OF KANSAS, INC. | $2K | — | $2K | 6.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE - WICHITA | 8100 E 32ND ST N STE 100 WICHITA, KS 67226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE NTL | 2850 GOLF RD ROLLING MEADOW, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $282 | $282 | 1.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE - WICHITA | 8100 E 32ND ST N STE 100 WICHITA, KS 67226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC NTL | 2850 GOLF RD ROLLNG MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $170 | $170 | 1.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE - WICHITA | 8100 E 32ND ST N STE 100 WICHITA, KS 67226 | SURENCY LIFE AND HEALTH | $1K | — | $1K | 9.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE - WICHITA | 8100 E 32ND ST N STE 100 WICHITA, KS 67226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC NTL | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $148 | $148 | 1.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE - WICHITA | 8100 E 32ND ST N WICHITA, KS 67226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $562 | — | $562 | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC NTL | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $73 | $73 | 1.95% |
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 | 119 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 203 | $778K |
| Dental | DELTA DENTAL OF KANSAS, INC. | 78 | $35K |
| Vision | SURENCY LIFE AND HEALTH | 67 | $11K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $29K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 11 | $4K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 203 | $778K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 203 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.