| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE INC. | P.O. BOX 3198 KOKOMO, IN 46904 | DELTA DENTAL PLAN OF ARKANSAS | $7K | — | $7K | 3.00% |
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE INC. | 1500 RIVERFRONT DR LITTLE ROCK, AR 722021797 | VISION SERVICE PLAN | $3K | — | $3K | 5.00% |
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE INC. | P.O. BOX 3198 LITTLE ROCK, AR 72203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 22.00% |
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE INC. | P.O. BOX 3198 LITTLE ROCK, AR 72203 | ZURICH AMERICAN INSURANCE COMPANY | $821 | — | $821 | 15.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES INC. | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ZURICH AMERICAN INSURANCE COMPANY | — | $821 | $821 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUEADVANTAGE ADMIN OR ARKANSAS EIN 71-0226428 CLAIMS PROCES | Claims processing Service code 12 | P.O. BOX 1460 LITTLE ROCK, AR 722031460 | $0 |
| DATAPATH ADMINISTRATIVE SER INC. EIN 71-0808497 ADMIN SERVICES | Plan Administrator Service code 14 | 1601 WESTPARK DR STE 9 LITTLE ROCK, AR 72204 | $0 |
| REGIONS INSURANCE INC. EIN 71-0621654 INS. BROKER | Insurance agents and brokers Service code 22 | 1500 RIVERFRONT DR. SUITE A LITTLE ROCK, AR 72202 | $0 |
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 | 565 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 565 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 565 | $351K |
| Dental | DELTA DENTAL PLAN OF ARKANSAS | 919 | $232K |
| Vision | VISION SERVICE PLAN | 473 | $54K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 982 | $178K |
| Short-term disability(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 982 | $493K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 982 | $178K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 565 | $351K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 796 | $348K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 982 | — |
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.