| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROFESSIONAL INSURANCE CONSULTANTS3 | P.O. BOX 1717 DODGE CITY, KS 67801 | DELTA DENTAL OF KANSAS | $56K | — | $56K | 4.98% |
| RHONDA ELAINE FERNANDEZ3 | 2202 FAIRWAY DRIVE DODGE CITY, KS 67801 | AETNA LIFE INSURANCE COMPANY | $25K | — | $25K | 2.43% |
| PROFESSIONAL INSURANCE CONSULTANTS3 | P.O. BOX 1717 DODGE CITY, KS 67801 | UNION SECURITY INSURANCE COMPANY | $22K | — | $22K | 6.23% |
| PROFESSIONAL INSURANCE CONSULTANTS3 | P.O. BOX 1717 DODGE CITY, KS 67801 | UNION SECURITY INSURANCE COMPANY | $68K | — | $68K | 20.14% |
| PROFESSIONAL INSURANCE CONSULTANTS3 | P.O. BOX 1717 DODGE CITY, KS 67801 | UNION SECURITY INSURANCE COMPANY | $21K | — | $21K | 30.04% |
| PROFESSIONAL INSURANCE CONSULTANTS3 | P.O. BOX 1717 DODGE CITY, KS 67801 | SURRENCY LIFE AND HEALTH | $24K | — | $24K | 99.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE EIN 35-1846036 NONE | Other services; Plan Administrator; Claims processing Service code 12 | — | $735K |
| AETNA EIN 06-6033492 NONE | Claims processing; Other services Service code 12 | — | $149K |
| CLEAR HEALTH STRATEGIES EIN 27-1374374 NONE | Claims processing; Plan Administrator; Other services Service code 12 | — | $73K |
| WPPA EIN 48-0959093 NONE | Other services; Claims processing Service code 12 | — | $50K |
| FIRST HEALTH EIN 20-1736437 NONE | Other services; Claims processing Service code 12 | — | $9K |
| CHANGE HEALTHCARE EIN 20-5716594 NONE | Other services; Claims processing Service code 12 | — | $7K |
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 | 2,469 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,469 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KANSAS | 2,015 | $1.1M |
| Vision | SURRENCY LIFE AND HEALTH | 1,641 | $24K |
| Life insurance(2 contracts) | UNION SECURITY INSURANCE COMPANY | 2,469 | $695K |
| Short-term disability(2 contracts) | UNION SECURITY INSURANCE COMPANY | 878 | $409K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 2,469 | $356K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY | 1,235 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,469 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.