| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TODD GILBERT INC,3 Filed as: TODD GILBERT INSURANCE AGENCY | 713 S. COLLEGE STREET MOUNTAIN HOME, AR 72653 | ARKANSAS BLUE CROSS AND BLUE SHIELD | $17K | — | $17K | 4.00% |
| TODD GILBERT INC,3 Filed as: TODD GILBERT INSURANCE AGENCY | 713 S. COLLEGE STREET MOUNTAIN HOME, AR 72653 | DELTA DENTAL PLAN OF ARKANSAS | $6K | — | $6K | 8.00% |
| TODD GILBERT INC,3 Filed as: TODD GILBERT INC. | 713 S. COLLEGE STREET MOUNTAIN HOME, AR 72653 | USABLE LIFE | $1K | — | $1K | 4.09% |
| TIMOTHY CAIN3 | 855 NICHOLAS ROAD SPRINGDALE, AR 72762 | USABLE LIFE | $184 | — | $184 | 0.60% |
| HERMAN AGENCY3 | 715 ENTERPRISE DR OAK BROOK, IL 60523 | TRANSAMERICA LIFE INSURANCE COMPANY | $561 | — | $561 | 1.94% |
| HAROLD SHERRY3 | 5 EAST 6TH ST MOUNTAIN HOME, AR 72653 | TRANSAMERICA LIFE INSURANCE COMPANY | $533 | — | $533 | 1.84% |
| TODD GILBERT INC,3 Filed as: TODD GILBERT INC. | 713 S. COLLEGE STREET MOUNTAIN HOME, AR 72653 | USABLE LIFE | $340 | — | $340 | 4.96% |
| TWIN LAKES INSURANCE3 | 707 N CARDINAL DR #2 MOUNTAIN HOME, AR 72653 | USABLE LIFE | $259 | — | $259 | 3.78% |
| YOUR BENEFITS AGENCY INC3 Filed as: YOUR BENEFITS AGENCY INC. | 17500 CHENAL PARKWAY, SUITE 150 LITTLE ROCK, AR 72223 | USABLE LIFE | $183 | — | $183 | 2.67% |
| TIMOTHY CAIN3 | 855 NICHOLAS ROAD SPRINGDALE, AR 72762 | USABLE LIFE | $103 | — | $103 | 1.50% |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ARKANSAS BLUE CROSS AND BLUE SHIELD | 218 | $417K |
| Dental | DELTA DENTAL PLAN OF ARKANSAS | 262 | $81K |
| Life insurance(2 contracts, 2 carriers) | USABLE LIFE | 129 | $60K |
| Short-term disability | USABLE LIFE | 16 | $7K |
| Long-term disability | USABLE LIFE | 129 | $31K |
| Prescription drug | ARKANSAS BLUE CROSS AND BLUE SHIELD | 218 | $417K |
| Other(2 contracts) | USABLE LIFE | 129 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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.