| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JACQUELINE K QUALIZZA3 | 12877 W 151ST STREET OLATHE, KS 66062 | BLUECROSS BLUESHIELD OF OKLAHOMA | $40K | — | $40K | 5.00% |
| CERESTA L HILL3 | 5216 NW 111TH STREET OKLAHOMA CITY, OK 73162 | AFLAC | $3K | $238 | $3K | 5.17% |
| JUDY C ELWOOD3 | 810526 S HIGHWAY 177 CARNEY, OK 74832 | AFLAC | $3K | — | $3K | 4.39% |
| DONNA CDEBACA STEWART3 Filed as: DONNA STEWART | 3501 FRENCH PARK DR STE E EDMOND, OH 73034 | AFLAC | $2K | $56 | $2K | 3.37% |
| BOBBY R STEWART3 | 3501 FRENCH PARK DRIVE SUITE E EDMOND, OK 73034 | AFLAC | $616 | $56 | $672 | 1.15% |
| BRIAN K EVERETT3 Filed as: BRIAN EVERETT | 2160 SANDPIPER DR BLANCHARD, OK 73010 | AFLAC | $514 | — | $514 | 0.88% |
| STACY HAMPTON3 | 2409 N KELLER DR STILLWATER, OK 74075 | AFLAC | $289 | — | $289 | 0.50% |
| CATRINA D DELLINGER3 | 617 E GREENWOOD LANE MUSTANG, OK 73064 | AFLAC | $246 | — | $246 | 0.42% |
| CAROLYN BENDER3 | 917 EGGLESTON STREET FORT COLLINS, OK 80524 | AFLAC | $108 | — | $108 | 0.19% |
| CHARLES D MANGUS3 | 1305 PULCHELLA WAY NEWCASTLE, OK 73065 | AFLAC | $87 | — | $87 | 0.15% |
| LARRY D DENNY3 | PO BOX 306 WETUMKA, OK 74883 | AFLAC | $85 | — | $85 | 0.15% |
| STEPHEN W SIMPSON3 | 540 CELTIC CT EDMOND, OK 73025 | AFLAC | $70 | — | $70 | 0.12% |
| TREY CDEBACA3 | 1004 EARL A RODKEY DR EDMOND, OK 73003 | AFLAC | $63 | — | $63 | 0.11% |
| KEVIN KHOURY3 | 918 NW 17TH ST OKLAHOMA CITY, OK 73106 | AFLAC | $51 | — | $51 | 0.09% |
| LISA B NEWPORT3 | 1009 SETTLERS DR EDMOND, OK 73034 | AFLAC | $50 | — | $50 | 0.09% |
| LESTER RAY BLACKSHEAR3 | 9192 SE 168TH COOK PL THE VILLAGES, FL 32162 | AFLAC | $43 | — | $43 | 0.07% |
| JOHN A WILLIAMS COMPANY INC3 | 20316 N COUNTY ROAD 3240 PAULS VALLEY, OK 73075 | AFLAC | $33 | — | $33 | 0.06% |
| COOPER SCOTT YEATES3 | 2133 E 2ND ST APT 4208 EDMOND, OK 73034 | AFLAC | $30 | — | $30 | 0.05% |
| HAL W MOFFATT3 Filed as: HAL MOFFATT | 1221 LAMPLIGHTER LN EDMOND, OK 73034 | AFLAC | $15 | — | $15 | 0.03% |
| JAMES MICHAEL WILLIAMS3 | 235 CHELSEA WAY SULPHUR, OK 73086 | AFLAC | $13 | — | $13 | 0.02% |
| JARRELL K PRENTICE3 | 1113 EAST DR EDMOND, OK 73034 | AFLAC | $10 | — | $10 | 0.02% |
| JOSHUA C ROLAN3 | 704 SEMINOLE DR PAULS VALLEY, OK 73075 | AFLAC | $10 | — | $10 | 0.02% |
| PAUL B BROUCHOUD3 | 604 MARK DR DEL CITY, OK 73115 | AFLAC | $9 | — | $9 | 0.02% |
| SHANE M OWEN3 | 8413 NW 106TH ST OKLAHOMA CITY, OK 73162 | AFLAC | $7 | — | $7 | 0.01% |
| SHARON J FITZPATRICK3 | 4516 KINDLING AVE GUTHRIE, OK 73044 | AFLAC | $7 | — | $7 | 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 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 15.05% |
| JUDY C ELWOOD3 Filed as: JUDY CHRISTINE ELWOOD | 810526 S HIGHWAY 177 CARNEY, OK 748324845 | AMERITAS LIFE INSURANCE CORP. | $637 | — | $637 | 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 | 114 | 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) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF OKLAHOMA | 128 | $801K |
| Dental | AFLAC | 60 | $58K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 63 | $6K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 114 | $81K |
| Short-term disability | AFLAC | 60 | $58K |
| Other(2 contracts, 2 carriers) | AFLAC | 114 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 128 | — |
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.