| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 2345 GRAND BLVD., SUITE 400 KANSAS CITY, MO 64108 | BLUE CROSS AND BLUE SHIELD OF KANSAS | $19K | — | $19K | 2.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS-WICHITA | 10333 E 21ST ST N STE 104 WICHITA, KS 67206 | DELTA DENTAL OF KANSAS, INC. | $7K | — | $7K | 8.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 12444 POWERSCOURT DRIVE SUITE 500 SAINT LOUIS, MO 63131 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 17.16% |
| TERESA BURNETT3 | 1112 E JAMES ST DERBY, KS 67037 | AFLAC | $2K | $102 | $2K | 8.61% |
| BRIAN M LEITZEL3 | 4201 SPRING DR CHENEY, KS 67025 | AFLAC | $233 | $24 | $257 | 1.14% |
| JOHN E WETIG3 | 103 S ROUPP ST HESSTON, KS 67062 | AFLAC | $193 | $7 | $200 | 0.89% |
| ASHLE BURNETT3 | 1112 E JAMES ST DERBY, KS 67037 | AFLAC | $171 | — | $171 | 0.76% |
| MARC LUTHER HOMAN3 | 11828 W CENTRAL AVE STE 100 WICHITA, KS 67212 | AFLAC | $170 | — | $170 | 0.76% |
| MICAH BOULANGER3 | 310 FAIRWOOD DR NICEVILLE, FL 32578 | AFLAC | $89 | — | $89 | 0.40% |
| CALEB GILMOUR3 Filed as: CALEB J GILMOUR | 515 S MAIN ST STE 105 WICHITA, KS 67202 | AFLAC | $72 | — | $72 | 0.32% |
| SPENCER H STELLJES3 | 338 N QUENTIN ST WICHITA, KS 67208 | AFLAC | $51 | — | $51 | 0.23% |
| WILLINGHAM INC3 Filed as: WILLINGHAM INC. | 35354 MISSION BELLEVIEW RD LOUISBURG, KS 66053 | AFLAC | $50 | — | $50 | 0.22% |
| SCOTT W LUTY3 | 524 E 30TH AVE HUTCHINSON, KS 67502 | AFLAC | $48 | — | $48 | 0.21% |
| RUSTY J HELIN3 | 2012 SE 9TH ST MOORE, OK 73160 | AFLAC | $36 | — | $36 | 0.16% |
| MARK ALAN BRYANT3 | 9122 W BIRCH LN WICHITA, KS 67212 | AFLAC | $36 | — | $36 | 0.16% |
| JUSTIN C CARSON3 | 7701 E KELLOGG DR STE 680 WICHITA, KS 67207 | AFLAC | $35 | — | $35 | 0.16% |
| NATHAN L HARRISON3 | 5301 E VISTA RICA ST PARADISE VALLEY, AZ 85253 | AFLAC | $30 | — | $30 | 0.13% |
| DARRELL CUSICK3 | 1204 N MANCHESTER AVE NEWTON, KS 67114 | AFLAC | $28 | — | $28 | 0.12% |
| BRANDON M UNREIN3 | 15275 SW INDIANOLA RD AUGUSTA, KS 67010 | AFLAC | $22 | — | $22 | 0.10% |
| BRIAN L PORTER3 | 8021 E DRESDEN LN WICHITA, KS 67207 | AFLAC | $18 | — | $18 | 0.08% |
| KATHY WIEDEMANN3 | 222 HIGH VIEW DR BOULDER, CO 80304 | AFLAC | $18 | — | $18 | 0.08% |
| SYLVESTER L THOMPSON3 | 1820 S STACEY ST WICHITA, KS 67207 | AFLAC | $14 | — | $14 | 0.06% |
| BRAD J SCHUMACHER3 | 2804 COUNTRY LN HAYS, KS 67601 | AFLAC | $13 | — | $13 | 0.06% |
| GARY GIARRATANO3 | 13309 W 73RD ST SHAWNEE, KS 66216 | AFLAC | $10 | — | $10 | 0.04% |
| TERRY S DECKER3 | 123401 EW 6 RD TURPIN, OK 73950 | AFLAC | $5 | — | $5 | 0.02% |
| KENNETH D MORRIS JR3 | 5410 PLYMOUTH DR LAWRENCE, KS 66049 | AFLAC | $3 | — | $3 | 0.01% |
| JONI S WOBORNY BUNKER3 | 4601 LICHEN LN MANHATTAN, KS 66503 | AFLAC | $2 | — | $2 | 0.01% |
| CHRISTOPHER THOMAS HIPP3 | 1601 MEADOW LN HAYS, KS 67601 | AFLAC | $2 | — | $2 | 0.01% |
| BRIAN MILLS3 | 1402 W LUCY WEBB RD RAYMORE, MO 64083 | AFLAC | $2 | — | $2 | 0.01% |
| JOHN A BACON3 | 1100 AUTUMN CIR UNIT 4 LOUISBURG, KS 66053 | AFLAC | $1 | — | $1 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | P.O. BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 9.60% |
No Schedule C service providers reported on this filing.
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 | 214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 102 | $795K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF KANSAS, INC. | 144 | $107K |
| Vision(2 contracts, 2 carriers) | AFLAC | 186 | $41K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 214 | $77K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 214 | $77K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 214 | $54K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 102 | $795K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 214 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.