| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS ADVANTAGE LLC3 | 1605 S EUCALYPTUS, STE 105 BROKEN ARROW, OK 74012 | DELTA DENTAL | $6K | — | $6K | 3.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE, STE 1900 TULSA, OK 74136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 3.19% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TX HWY S BLDG II, STE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $1K | $1K | 1.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1350 S BOULDER AVE, STE 1000 PO BOX 1440 TULSA, OK 74101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 5.39% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TX HWY S BLDG II, STE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $672 | $672 | 1.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1350 S BOULDER AVE, STE 1000 TULSA, OK 74119 | VISION SERVICE PLAN | $5K | — | $5K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 S YALE, STE 1900 TULSA, OK 74136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TX HWY S BLDG II, STE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $114 | $114 | 1.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH CARE SERVICE CORPORATION EIN 36-1236610 NONE | Direct payment from the plan; Other services; Participant communication; Claims processing Service code 12 | — | $173K |
| MERCER NONE | Direct payment from the plan; Claims processing; Participant communication Service code 12 | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | $35K |
| HUB INTERNATIONAL NONE | Claims processing; Direct payment from the plan; Participant communication Service code 12 | 300 N. LASALLE ST, 17TH FLOOR TULSA, OK 60654 | $30K |
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 | 374 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 375 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 24 | $119K |
| Dental | DELTA DENTAL | 277 | $147K |
| Vision | VISION SERVICE PLAN | 364 | $47K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 358 | $114K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 358 | $58K |
| Stop-loss / reinsurancereinsurance | HEALTH CARE SERVICE CORPORATION | 445 | $246K |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 377 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 445 | — |
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."
No prospect flags tripped on this filing.