| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RON BOWEN3 | CREATIVE BENEFIT CONCEPTS 740 N YORK SUITE B MUSKOGEE, OK 74403 | BLUE CROSS BLUE SHIELD OF OKLAHOMA | $60K | — | $60K | 4.03% |
| RON BOWEN3 | CREATIVE BENEFIT CONCEPTS 740 N YORK SUITE B MUSKOGEE, OK 74403 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $26K | — | $26K | 15.00% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $52 | $52 | 0.03% |
| DELTA DENTAL HOUSE ACCOUNT0 | P O BOX 54709 OKLAHOMA CITY, OK 731541709 | DELTA DENTAL OF OKLAHOMA | $5K | $6K | $11K | 13.65% |
| RON BOWEN3 | CREATIVE BENEFIT CONCEPTS 740 N YORK SUITE B MUSKOGEE, OK 74403 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 17.51% |
| BATES INSURANCE GROUP LLC3 | 519 NORTH 1ST PONCA CITY, OK 74601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $260 | $90 | $350 | 2.99% |
| ANNA CHRISTINE POOLE3 | 4800 W 108TH STREET #1013 OVERLAND PARK, KS 66211 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $163 | $2 | $165 | 1.41% |
| KERRI JOANN MUSGROVE3 | 10028 S 99TH EAST AVENUE TULSA, OK 74133 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $125 | — | $125 | 1.07% |
| KELLY W PUGH3 | 7367 S 286TH EAST AVENUE TULSA, OK 74133 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.21% |
| ROBERT K PALMER3 | 415 FOREMAN AVENUE NORMAN, OK 73069 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.03% |
| JOSEPH F PALMER3 | P O BOX 270658 OKLAHOMA CITY, OK 73137 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.03% |
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 | 144 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF OKLAHOMA | 175 | $1.5M |
| Dental | DELTA DENTAL OF OKLAHOMA | 95 | $79K |
| Vision | VISION SERVICE PLAN | 90 | $12K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 144 | $172K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 144 | $172K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 144 | $172K |
| Other(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 59 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.