| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEITH A PFAUTZ3 | 1208 N MADISON AVE NEWTON, KS 67114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $160 | $2K | 4.63% |
| VAN SWANSON3 Filed as: VAN SWANSON INC | 2272 FRINGE TREE TRL THE VILLAGES, FL 32162 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.99% |
| BRIAN PORTER3 | 8021 E DRESSDEN LN WICHITA, KS 67207 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $443 | — | $443 | 1.30% |
| GENE BISSINGER3 | 4077 SNOWGOOSE ST SIMI VALLEY, CA 93065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $299 | $8 | $307 | 0.90% |
| RON BOWLING3 | 8575 W 110TH ST OVERLAND PARK, KS 66210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $223 | $65 | $288 | 0.84% |
| MAUREEN E CONRAN3 | 8575 WEST 110TH STREET OVERLAND PARK, KS 66210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $195 | $60 | $255 | 0.75% |
| MARILYN B BOWLING3 | 8447 SUMMIT ST LENEXA, KS 66215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $195 | $54 | $249 | 0.73% |
| RYAN BOWLING3 | 8575 WEST 110TH STREET OVERLAND PARK, KS 66210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $93 | $73 | $166 | 0.49% |
| RENEE CARTWRIGHT3 | 3713 W 140TH ST LEAWOOD, KS 66224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $116 | — | $116 | 0.34% |
| LINDSAY BURGESS3 | 3505 W 63RD ST MISSION HILLS, KS 66208 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $78 | $2 | $80 | 0.23% |
| SAMUEL A MCFALL3 | 609 NORTH BROADWAY WICHITA, KS 67214 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $38 | $71 | 0.21% |
| THOMAS A BRYON3 | PO BOX 2628 SHAWNEE MISSION, KS 66201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | — | $65 | 0.19% |
| SUSAN GOLD STOKES3 Filed as: SUSAN G STOKES | 3113 W 187TH PL TORRANCE, CA 90504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | — | $58 | 0.17% |
| PHYLLIS ILENE SHALLMAN3 | 1121 UNIVERSITY BLVD W SILVER SPRING, MD 20902 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | $6 | $42 | 0.12% |
| ROBERT D RICHEY3 | PO BOX 454 VALLEY CENTER, KS 67147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $2 | $35 | 0.10% |
| THE STINGRAY GROUP INC3 | 7324 RICHARDS DR SHAWNEE, KS 66216 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS & BLUE SHIELD OF KANSAS EIN 48-0952857 ADMINISTRATOR | Recordkeeping fees; Contract Administrator Service code 13 | — | $114K |
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 | 476 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 476 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | ADVANCE INSURANCE COMPANY OF KANSAS | 184 | $9K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS AND BLUE SHIELD OF KANSAS | 476 | $235K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 184 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 476 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.