| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JACQUELINE K QUALIZZA3 Filed as: JACQUELINE KAY QUALIZZA | 12877 W 151ST ST OLATHE, KS 66062 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $33K | $36K | 4.04% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC - KS & MO | 2340 DES PLAINS RIVER RD STE 16G DES PLAINES, IL 60018 | UNITEDHEALTHCARE INSURANCE COMPANY | $7K | — | $7K | 0.75% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC KS & MO | 475 MARTINGALE RD SCHAUMBURG, IA 60173 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 0.18% |
| CERESTA L HILL3 | 5216 NW 111TH STREET OKLAHOMA CITY, OK 73162 | AFLAC | $2K | $118 | $2K | 4.46% |
| JUDY C ELWOOD3 | 810526 S HIGHWAY 177 CARNEY, OK 74832 | AFLAC | $2K | — | $2K | 3.68% |
| DONNA CDEBACA STEWART3 Filed as: DONNA STEWART | 3501 FRENCH PARK DR STE E EDMOND, OH 73034 | AFLAC | $1K | $27 | $1K | 2.39% |
| BOBBY R STEWART3 | 3501 FRENCH PARK DRIVE SUITE E EDMOND, OK 73034 | AFLAC | $516 | — | $516 | 1.00% |
| NOT PROVIDED3 | 5840 SCARLETT OAK RD GUTHRIE, OK 73044 | AFLAC | $403 | — | $403 | 0.78% |
| BRIAN K EVERETT3 | 2160 SANDPIPER DR BLANCHARD, OK 73010 | AFLAC | $367 | $27 | $394 | 0.76% |
| CATRINA D DELLINGER3 | 617 E GREENWOOD LANE MUSTANG, OK 73064 | AFLAC | $170 | — | $170 | 0.33% |
| CAROLYN BENDER3 | 917 EGGLESTON STREET FORT COLLINS, CO 80524 | AFLAC | $99 | — | $99 | 0.19% |
| CHARLES D MANGUS3 | 1305 PULCHELLA WAY NEWCASTLE, OK 73065 | AFLAC | $72 | — | $72 | 0.14% |
| LARRY D DENNY3 | PO BOX 306 WETUMKA, OK 74883 | AFLAC | $62 | — | $62 | 0.12% |
| NOT PROVIDED3 | 5840 SCARLETT OAK RD GUTHRIE, OK 73044 | AFLAC | $46 | — | $46 | 0.09% |
| STEPHEN W SIMPSON3 | 540 CELTIC CT EDMOND, OK 73025 | AFLAC | $39 | — | $39 | 0.08% |
| KEVIN KHOURY3 | 920 NW 17TH ST OKLAHOMA CITY, OK 73106 | AFLAC | $34 | — | $34 | 0.07% |
| LESTER RAY BLACKSHEAR3 | 9192 SE 168TH COOK PL THE VILLAGES, FL 32162 | AFLAC | $34 | — | $34 | 0.07% |
| JOHN A WILLIAMS COMPANY INC3 | 20316 N COUNTY ROAD 3240 PAULS VALLEY, OK 73075 | AFLAC | $25 | — | $25 | 0.05% |
| NOT PROVIDED3 | 906 CANADIAN AVE PURCELL, OK 73080 | AFLAC | $23 | — | $23 | 0.04% |
| NOT PROVIDED3 | 1009 SETTLERS DR EDMOND, OK 73034 | AFLAC | $22 | — | $22 | 0.04% |
| NOT PROVIDED3 | 201 RENNIE RD PAULS VALLEY, OK 73075 | AFLAC | $13 | — | $13 | 0.03% |
| HAL W MOFFATT3 Filed as: HAL MOFFATT | 1221 LAMPLIGHTER LN EDMOND, OK 73034 | AFLAC | $11 | — | $11 | 0.02% |
| JOSHUA C ROLAN3 | 704 SEMINOLE DR PAULS VALLEY, OK 73075 | AFLAC | $7 | — | $7 | 0.01% |
| PAUL B BROUCHOUD3 | 604 MARK DR DEL CITY, OK 73115 | AFLAC | $7 | — | $7 | 0.01% |
| NOT PROVIDED3 | 12512 N COUNTY ROAD 3232 PAOLO, OK 73074 | AFLAC | $6 | — | $6 | 0.01% |
| JARRELL K PRENTICE3 | 1113 EAST DR EDMOND, OK 73034 | AFLAC | $6 | — | $6 | 0.01% |
| SHANE M OWEN3 | 8413 NW 106TH ST OKLAHOMA CITY, OK 73162 | AFLAC | $5 | — | $5 | 0.01% |
| EDWARD A HALL JR3 Filed as: EDWARD HALL JR | 2224 WOODMARSH CIR AUBURN, GA 30011 | AFLAC | $2 | — | $2 | 0.00% |
| JACQUELINE K QUALIZZA3 | ASSOCIATION INSURANCE SERVICES 12877 W 151TH STREET OLATHE, KS 66062 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC - MISSOURI | 5110 N 4TH STREET STE 234 PHOENIX, AZ 85018 | UNITEDHEALTHCARE INSURANCE COMPANY | $911 | — | $911 | 3.32% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC - KS & MO | 5110 N 4TH STREET STE 234 PHOENIX, AZ 85018 | UNITEDHEALTHCARE INSURANCE COMPANY | $115 | — | $115 | 0.42% |
| JUDY C ELWOOD3 Filed as: JUDY CHRISTINE ELWOOD | 810526 S HIGHWAY 177 CARNEY, OK 74832 | AMERITAS LIFE INSURANCE CORP. | $1K | — | $1K | 10.00% |
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 | 133 | 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. |
| Total participants (= "Plan participants" tile) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 146 | $888K |
| Dental | AFLAC | 58 | $52K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 68 | $11K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 133 | $79K |
| Short-term disability | AFLAC | 58 | $52K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 146 | $888K |
| Other(2 contracts, 2 carriers) | AFLAC | 133 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 146 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.