| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JACK D. MCINNES IV3 Filed as: JACK D MCINNES IV | 4300 SHAWNEE MISSION PARKWAY FAIRWAY, KS 66205 | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS AND BLUE SHIELD | $0 | $0 | $0 | 0.00% |
| JACK DUNCAN MCINNES IV3 | 4300 SHAWNEE MISSION PKWY #100 FAIRWAY, KS 66205 | KAISER FOUNDATION HEALTH PLAN INC. | $16K | $0 | $16K | 2.19% |
| JACK D. MCINNES IV3 | 4300 SHAWNEE MISSION PKWY #100 FAIRWAY, KS 66205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $61K | $0 | $61K | 9.55% |
| MCINNES GROUP, INC.3 | 4300 SHAWNEE MISSION PKWY #100 FAIRWAY, KS 66205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $5K | $5K | 0.75% |
| JACK D. MCINNES IV3 | 4300 SHAWNEE MISSION PARKWAY FAIRWAY, KS 66205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $88K | $0 | $88K | 25.04% |
| MCINNES GROUP, INC.3 Filed as: MCINNES GROUP,INC. | 4300 SHAWNEE MISSION PARKWAY FAIRWAY, KS 66205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 0.76% |
| DAVID W WIGGINS3 Filed as: DAVID W. WIGGINS | 8900 STATE LINE RD 350 LEAWOOD, KS 66206 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $9 | $4K | 6.67% |
| J. DUNCAN MCINNES IV3 | 4300 SHAWNEE MISSION PKWY 100 FAIRWAY, KS 66205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 4.77% |
| MCINNES GROUP, INC.3 | 4300 SHAWNEE MISSION PKWY 100 FAIRWAY, KS 66205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $25 | $25 | 0.04% |
| DAVID W WIGGINS3 Filed as: DAVID W. WIGGINS | 1111 MAIN STREET KANSAS CITY, MO 64105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $5 | $1K | 3.41% |
| MCINNES GROUP, INC.3 | 4300 SHAWNEE MISSION PARKWAY FAIRWAY, KS 66205 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $564 | $0 | $564 | 1.34% |
| JACK D. MCINNES IV3 | 4300 SHAWNEE MISSION PARKWAY FAIRWAY, KS 66205 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $473 | $0 | $473 | 1.12% |
| MCINNES GROUP, INC.3 | 4300 SHAWNEE MISSION PARKWAY 100 FAIRWAY, KS 66205 | EAP CONSULTANTS, INC. | $1K | $0 | $1K | 5.77% |
| DAVID W WIGGINS3 Filed as: DAVID W. WIGGINS | 8900 STATE LINE RD LEAWOOD, KS 66206 | FIRST UNUM LIFE INSURANCE COMPANY | $6 | $0 | $6 | 3.05% |
| JACK D. MCINNES IV3 Filed as: JACK D. MCINNES | 4300 SHAWNEE MISSION PKWY #100 FAIRWAY, KS 66205 | FIRST UNUM LIFE INSURANCE COMPANY | $4 | $0 | $4 | 2.03% |
| MCINNES GROUP, INC.3 | 4300 SHAWNEE MISSION PARKWAY 100 FAIRWAY, KS 66205 | DELTA DENTAL OF KANSAS, INC. | $4K | $0 | $4K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 NETWORK PHARMACY MARGIN | Float revenue; Other fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing Service code 12 | — | $515K |
| JACK D MCINNES SALES & BASE COMMISSION | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 4300 SHAWNEE MISSION PARKWAY #100 FAIRWAY, KS 66205 | $0 |
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 | 2,116 | 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) | 2,116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 2,116 | $1.4M |
| Dental | DELTA DENTAL OF KANSAS, INC. | 960 | $0 |
| Vision | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 2,116 | $1.4M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,153 | $636K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,153 | $636K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,153 | $636K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 2,116 | $1.4M |
| Other(6 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,153 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,116 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.