| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 6.27% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $738 | $2K | 1.54% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $2K | $12K | 10.39% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH ST., STE 600 KANSAS CITY, MO 64112 | DELTA DENTAL | $6K | — | $6K | 6.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3856 S BOULEVARD STE 100 EDMOND, OK 73013 | DELTA DENTAL | $2K | — | $2K | 3.53% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 600 KANSAS CITY, MO 64112 | DELTA DENTAL | $2K | — | $2K | 2.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3856 S BOULEVARD STE 100 EDMOND, OK 73013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $82 | $2K | 14.72% |
| MARILYN K EMBERSON3 | 7220 N HAMMOND AVENUE OKLAHOMA CITY, OK 73132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $84 | $1K | 7.78% |
| WILLIAM D STAEDKE3 Filed as: WILLIAM D. STAEDKE | 25695 E 71ST STREET BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $947 | $277 | $1K | 7.76% |
| KELLY W PUGH3 | 7367 S 286TH EAST AVE BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $348 | $14 | $362 | 2.29% |
| SHANNON MARIE BALDWIN3 | 10222 E 114TH STREET S BIXBY, OK 74008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.22% |
| CARRIE ANN CAMPBELL3 | 5121 REDBUD DRIVE SAND SPRINGS, OK 74063 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.03% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | EYEMED VISION CARE | $1K | — | $1K | 9.05% |
| JOHNSON RESOURCES3 | 7373 E DOUBLETREE RANCH #200 SCOTTSDALE, AZ 85258 | EYEMED VISION CARE | $250 | — | $250 | 1.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3856 S BOULEVARD STE 100 EDMOND, OK 73013 | EYEMED VISION CARE | $543 | — | $543 | 5.99% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | EYEMED VISION CARE | $294 | — | $294 | 3.24% |
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 | 150 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL | 142 | $161K |
| Vision(2 contracts) | EYEMED VISION CARE | 261 | $23K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 150 | $255K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 150 | $255K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 150 | $255K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 150 | $270K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 261 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.