Form 5500 · Employee benefit plan · DODGE CITY, KS
ARROWHEAD WEST INC.
The filing calls this plan ARROWHEAD WEST INC. FLEXIBLE WELFARE BENEFIT PLAN.
Public Form 5500 records show how ARROWHEAD WEST INC. of DODGE CITY, KS, a health care and social assistance employer, structures its employee benefits. Its broker of record is TERESA BURNETT. Coverage is written through BLUE CROSS BLUE SHEILD and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 48-0847237 · plan 501 · plan year 2025, filed Jul 31, 2026
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 5 insured contracts covering health, dental, vision and life; the largest, with BLUE CROSS BLUE SHEILD, covers 167 people.
The filing declares health, dental, life and disability. Disability appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium across the insured contracts is $552,771, with $20,953 in disclosed broker commissions — about 3.8% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
TERESA BURNETT is the broker of record on 1 of the 5 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AFLAC | Life | 112 | Jan 1, 2026 | $68,025 | $13,332 |
| DELTA DENTAL OF KANSAS, INC. | Dental | 147 | Jan 1, 2026 | $60,994 | $3,332 |
| ADVANCE INSURANCE COMPANY OF KANSAS | Life | 188 | Jan 1, 2026 | $17,281 | $2,478 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Vision | 117 | Jan 1, 2026 | $18,113 | $1,811 |
| BLUE CROSS BLUE SHEILD | Health | 167 | Jan 1, 2026 | $388,358 | $0 |
Premium and claims on this contract
BLUE CROSS BLUE SHEILD, contract 96165. For the contract year on this filing, the carrier reported $388,358 in premium earned and $556,786 in claims incurred. Dividing one by the other gives 143%.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. The service providers are named on Schedule C of this filing. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 280 employees, 11 recordable cases, 27 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
Subscribers see how this compares with similar plans in Kansas. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
More employer plans in Kansas — largest plans, brokers, carriers and renewal months.