| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-AMERICA | 425 WEST CAPITOL AVENUE SUITE 3550 LITTLE ROCK, AR 72201 | GUARDIAN | $19K | $6K | $25K | 13.07% |
| MICHAEL DUNN MULLEN3 Filed as: MICHAEL MULLEN | 2607 E 14TH ST TULSA, OK 74104 | COMPANION LIFE | $3K | — | $3K | 5.09% |
| DIANNA S ROBERTSON3 Filed as: DIANNA ROBERTSON | 7421 NW 105TH STREET OKLAHOMA CITY, OK 73162 | COMPANION LIFE | $2K | — | $2K | 2.55% |
| MICHAEL DUNN MULLEN3 Filed as: MICHAEL D MULLEN (AGT NO. 26AJE) | 2607 E 14TH ST TULSA, OK 74104 | 5STAR LIFE INSURANCE COMPANY | $1K | — | $1K | 5.59% |
| INSURANCE NETWORK AGENCY3 | C/O LOREN L THETFORD 4835 S FULTON AVE #101 TULSA, OK 74135 | 5STAR LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| MICHAEL DUNN MULLEN3 Filed as: MICHAEL D MULLEN | 2315 S IRVINGTON AVE TULSA, OK 74114 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.50% |
| DIANNA S ROBERTSON3 | WORKSITE RESOURCE CENTER DBA EMPLOY 7421 NAW 105TH STREET OKLAHOMA CITY, OK 73162 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $506 | — | $506 | 4.63% |
| MICHAEL DUNN MULLEN3 Filed as: MICHAEL D MULLEN (AGT. NO. 26AJE) | 2607 E 14TH ST TULSA, OK 74104 | 5STAR LIFE INSURANCE COMPANY | $1K | — | $1K | 14.84% |
| INSURANCE NETWORK AGENCY3 | C/O LOREN L. THETFORD 4835 S. FULTON AVE #101 TULSA, OK 74135 | 5STAR LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
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 | 282 | 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) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITYCARE HMO, INC. | 291 | $3K |
| Dental | GUARDIAN | 282 | $188K |
| Vision | GUARDIAN | 282 | $188K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 282 | $198K |
| Short-term disability | COMPANION LIFE | 287 | $68K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 24 | $11K |
| Other(3 contracts, 3 carriers) | GUARDIAN | 291 | $216K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.