| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JACK D. MCINNES IV3 Filed as: JACK D MCINNES IV | 3500 W. 75TH STREET 200 PRAIRIE VILLAGE, KS 66208 | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS AND BLUE SHIELD | $154K | $0 | $154K | 13.28% |
| JACK DUNCAN MCINNES IV3 | 3500 W. 75TH STREET #200 PRAIRIE VILLAGE, KS 66208 | KAISER FOUNDATION HEALTH PLAN INC. | $17K | $0 | $17K | 1.83% |
| JACK D. MCINNES IV3 | 3500 W. 75TH STREET #200 PRAIRIE VILLAGE, KS 66208 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $71K | $0 | $71K | 8.81% |
| MCINNES GROUP, INC.3 | 3500 W. 75TH STREET #200 PRAIRIE VILLAGE, KS 66208 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $6K | $6K | 0.70% |
| JACK D. MCINNES IV3 | 3500 W. 75TH STREET 200 PRAIRIE VILLAGE, KS 66208 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $90K | $0 | $90K | 23.84% |
| MCINNES GROUP, INC.3 Filed as: MCINNES GROUP,INC. | 3500 W. 75TH STREET 200 PRAIRIE VILLAGE, KS 66208 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 0.72% |
| MACLELLAN, DANIEL, OWEN3 | PO BOX 58434 NASHVILLE, TN 37205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $589 | $10K | 9.46% |
| J. DUNCAN MCINNES IV3 | 3500 W. 7TTH STREET #200 PRAIRIE VILLAGE, KS 66208 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 3.69% |
| DAVID W WIGGINS3 Filed as: DAVID W. WIGGINS | 8900 STATE LINE RD 350 LEAWOOD, KS 66206 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $15 | $4K | 3.35% |
| MCINNES GROUP, INC.3 | 3500 W. 75TH STREET 200 PRAIRIE VILLAGE, KS 66208 | EAP CONSULTANTS, INC. | $902 | $0 | $902 | 3.99% |
| MCINNES GROUP, INC.3 | 3500 W. 75TH STREET 200 PRAIRIE VILLAGE, KS 66208 | DELTA DENTAL OF KANSAS, INC. | $5K | $0 | $5K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 SERVICE & FEES | Insurance agents and brokers; Other services; Other commissions; Contract Administrator; Claims processing; Insurance brokerage commissions and fees; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $555K |
| EXPRESS SCRIPTS, INC. EIN 31-1714795 DRUG COMPANY | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue Service code 12 | — | $122K |
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 | 1,272 | 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) | 1,272 | 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 | 2,457 | $1.2M |
| Dental | DELTA DENTAL OF KANSAS, INC. | 1,109 | $0 |
| Vision | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 2,457 | $1.2M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,272 | $803K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,272 | $803K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,272 | $803K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS AND BLUE SHIELD | 2,457 | $1.2M |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,272 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,457 | — |
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.