| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE HATCHER AGENCY | P.O. BOX 3505 LITTLE ROCK, AR 72203 | QCA HEALTH PLAN | $18K | — | $18K | 2.61% |
| THE HATCHER AGENCY | P.O. BOX 3505 LITTLE ROCK, AR 72203 | DELTA DENTAL PLAN OF ARKANSAS | $10K | — | $10K | 10.00% |
| THE HATCHER AGENCY | P.O. BOX 3505 LITTLE ROCK, AR 72203 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $5K | — | $5K | 20.00% |
| THE HATCHER AGENCY | P.O. BOX 3505 LITTLE ROCK, AR 72203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $5K | 21.61% |
| THE HATCHER AGENCY | P.O. BOX 3505 LITTLE ROCK, AR 72203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 21.41% |
| THE HATCHER AGENCY | P.O. BOX 3505 LITTLE ROCK, AR 72203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 22.51% |
| THE HATCHER AGENCY | P.O. BOX 3505 LITTLE ROCK, AR 72203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $673 | $283 | $956 | 21.31% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| QUAL CHOICE HEALTH INSURANCE EIN 71-0794605 NONE | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | 12615 CHENAL PARKWAY, SUITE 300 LITTLE ROCK, AR 72211 | $18K |
| DELTA DENTAL OF ARKANSAS EIN 71-0561140 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | 1513 COUNTRY CLUB ROAD SHERWOOD, AR 72120 | $10K |
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 | 118 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QCA HEALTH PLAN | 171 | $703K |
| Dental | DELTA DENTAL PLAN OF ARKANSAS | 237 | $102K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 112 | $24K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $23K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 71 | $21K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 48 | $17K |
| Prescription drug | QCA HEALTH PLAN | 171 | $703K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 237 | — |
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.