| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WASHINGTON STREET INSURANCE GROUP3 | 12318 SOUTH CICERO AVENUE ALSIP, IL 60803 | AMALGAMATED LIFE INSURANCE COMPANY | $8K | — | $8K | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF KANSAS EIN 48-0952857 CLAIM PROCESSING | Claims processing; Insurance services; Actuarial Service code 11 | 133 SW TOPEKA BLVD TOPEKA, KS 66629 | $293K |
| CIGNA HEALTHCARE CLAIMS PROCESSING | Actuarial; Insurance services; Claims processing Service code 11 | — | $259K |
| SPENCER FANE BRITT & BROWNE LLP EIN 44-0561981 LEGAL | Legal Service code 29 | 1000 WALNUT ST SUITE 1400 KANSAS CITY, MO 64106 | $173K |
| JOE D PUCCI EIN 48-6127146 ADMINISTRATOR | Plan Administrator Service code 14 | 505 S BROADWAY SUITE 117 WICHITA, KS 67202 | $86K |
| REDSTONE ADVISORS EIN 48-1105831 INVESTMENT ADVISOR | Investment advisory (plan); Investment management Service code 27 | 8100 E 22ND ST N SUITE 800 WICHITA, KS 67226 | $82K |
| TERESA ROTRAMEL EIN 48-6127146 EMPLOYEE | Employee (plan) Service code 30 | 505 S BROADWAY SUITE 117 WICHITA, KS 67202 | $56K |
| PAULA URTON EIN 48-6127146 EMPLOYEE | Employee (plan) Service code 30 | 505 S BROADWAY SUITE 117 WICHITA, KS 67202 | $49K |
| TAFT-HARTLEY SERVICES EIN 45-5196696 CONSULTANT | Consulting (general) Service code 16 | 481 NW WINCHESTER CT BLUE SPRINGS, MO 64014 | $43K |
| BEST DOCTORS INC MEDICAL CONSULTING | Other services Service code 49 | 60 STATE STREET #600 BOSTON, MA 02109 | $38K |
| MORROW & CO., LLC EIN 48-1142797 AUDITOR | Accounting (including auditing) Service code 10 | 421 E 3RD ST N WICHITA, KS 67202 | $36K |
| DELTA DENTAL OF KANSAS EIN 48-0793267 CLAIMS PROCESSING | Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 1619 N WATERFRONT PARKWAY WICHITA, KS 67278 | $35K |
| EMPRISE BANK EIN 74-2809141 CUSTODIAN | Other services; Custodial (securities) Service code 19 | 257 N BROADWAY WICHITA, KS 67202 | $28K |
| KATHY LUTZ EIN 46-6127146 EMPLOYEE | Employee (plan) Service code 30 | 505 S BROADWAY SUITE 117 WICHITA, KS 67202 | $24K |
| INSURANCE REIMBURSEMENT SPECIALIST CLAIMS REVIEW | Other services Service code 49 | 2021 N AMIDON AVE #130 WICHITA, KS 67203 | $6K |
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 | 995 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 26 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,021 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | AMALGAMATED LIFE INSURANCE COMPANY | 1,008 | $422K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,008 | — |
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.