| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | — | BLUE CROSS & BLUE SHIELD OF KANSAS CITY | $45K | $9K | $55K | 4.18% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: THE ROBERT E MILLER INS AGENCY | 903 E 104TH ST STE 800 KANSAS CITY, MO 64131 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | $1K | $9K | 5.93% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 225 SCHILLING CIR STE 150 HUNT VALLEY, MD 21031 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 2.30% |
| ROBERT E. MILLER INSURANCE AGENCY3 | 903 EAST 104TH STREET, SUITE 800 KANSAS CITY, MO 64131 | DELTA DENTAL OF KANSAS, INC. | $2K | — | $2K | 2.76% |
| ROBERT E. MILLER INSURANCE AGENCY3 | 903 E 104TH ST STE 800 KANSAS CITY, MO 64131 | VISION SERVICE PLAN | $430 | — | $430 | 3.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29982 NETWORK PLACE CHICAGO, IL 60673 | VISION SERVICE PLAN | $391 | — | $391 | 3.51% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS & BLUE SHIELD OF KANSAS CITY | 172 | $1.3M |
| Dental | DELTA DENTAL OF KANSAS, INC. | 100 | $73K |
| Vision | VISION SERVICE PLAN | 83 | $11K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 142 | $149K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 142 | $149K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 142 | $149K |
| Prescription drug | BLUE CROSS & BLUE SHIELD OF KANSAS CITY | 172 | $1.3M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 142 | $149K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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."
Final-filing indicator set. Plan is winding down; don't waste sales effort here.