| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 412 WICHITA, KS 67202 | BLUE CROSS AND BLUE SHIELD OF KANSAS | $35K | $0 | $35K | 4.09% |
| TERESA BURNETT3 | 1112 EAST JAMES STREET DERBY, KS 67037 | AFLAC | $914 | $0 | $914 | 6.33% |
| PATRICIA ZOELLER3 | PO BOX 181 KINGMAN, KS 67068 | AFLAC | $862 | $23 | $885 | 6.13% |
| CALEB GILMOUR3 Filed as: CALEB J. GILMOUR | 515 SOUTH MAIN STREET, SUITE 105 WICHITA, KS 67202 | AFLAC | $272 | $5 | $277 | 1.92% |
| BRANDON M UNREIN3 Filed as: BRANDON M. UNREIN | 15275 SW INDIANOLA ROAD AUGUSTA, KS 67010 | AFLAC | $226 | $0 | $226 | 1.57% |
| ASHLE BURNETT3 Filed as: ASHLE BURNETT AND OTHER AGENTS | 1112 EAST JAMES STREET DERBY, KS 67037 | AFLAC | $173 | $0 | $173 | 1.20% |
| BRAD J SCHUMACHER3 Filed as: BRAD J. SCHUMACHER | 2804 COUNTRY LANE HAYS, KS 67601 | AFLAC | $154 | $0 | $154 | 1.07% |
| BRIAN M LEITZEL3 Filed as: BRIAN M. LEITZEL | 7920 WEST KELLOGG DRIVE, SUITE 103 WICHITA, KS 67209 | AFLAC | $130 | $0 | $130 | 0.90% |
| IMA, INC.3 | UNKNOWN WICHITA, KS 67207 | SURENCY LIFE AND HEALTH | $1K | $0 | $1K | 10.00% |
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 | 110 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 245 | $852K |
| Dental | BLUE CROSS AND BLUE SHIELD OF KANSAS | 245 | $852K |
| Vision | SURENCY LIFE AND HEALTH | 65 | $11K |
| Life insurance | AFLAC | 22 | $14K |
| Short-term disability | AFLAC | 22 | $14K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 245 | $852K |
| Other | AFLAC | 22 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 245 | — |
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.
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.