Form 5500 · Employee benefit plan · DODGE CITY, KS
SERVI-TECH INC
The filing calls this plan SERVI-TECH INC HEALTH INSURANCE PLAN.
SERVI-TECH INC of DODGE CITY, KS files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is IMA FINANCIAL GROUP. Coverage is written through BLUE CROSS AND BLUE SHIELD OF KANSAS. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 48-0823938 · plan 503 · plan year 2025, filed Jun 26, 2026
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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.
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 1 insured contract covering health and dental; the largest, with BLUE CROSS AND BLUE SHIELD OF KANSAS, covers 361 people.
Reported premium across the insured contracts is $2,277,138, with $37,536 in disclosed broker commissions — about 1.6% 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.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF KANSAS | Health, Dental | 361 | Jan 1, 2026 | $2,277,138 | $37,536 |
Premium and claims on this contract
BLUE CROSS AND BLUE SHIELD OF KANSAS, contract 483077173. For the contract year on this filing, the carrier reported $2,277,138 in premium earned and $2,097,723 in claims incurred. Dividing one by the other gives 92%.
- BLUE CROSS AND BLUE SHIELD OF KANSAS, contract 483077173 reported $145,594 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
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. We publish company names only.
Other plans filed by this employer
How this plan compares
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