| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTHSMART BENEFIT SOLUTIONS3 | 222 W. LAS COLINAS BLVD SUITE 500N IRVING, TX 75039 | HCC LIFE INSURANCE COMPANY | $2K | — | $2K | 1.00% |
| SCOUT BENEFITS GROUP LLC3 Filed as: SCOUT BENEFITS GROUP, LLC | 500 N WALKER SUITE 100 OKLAHOMA CITY, OK 73102 | PRUDENTIAL INSURANCE CO. | $3K | — | $3K | 7.50% |
| ASSURANCE AGENCY LTD3 Filed as: MUTUAL ASSURANCE AGENCY INC. | P.O. BOX 42096 OKLAHOMA CITY, OK 73123 | SYMETRA LIFE INSURANCE CO. | $4K | — | $4K | 14.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHSMART BENEFIT SOLUTIONS, INC. EIN 36-4099199 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $64K |
| FIRST HEALTH EIN 20-1736437 PPO PROVIDER | Other services Service code 49 | — | $6K |
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 | 140 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 127 | $247K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE CO. | 146 | $71K |
| Long-term disability | SYMETRA LIFE INSURANCE CO. | 146 | $28K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 127 | $247K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE CO. | 146 | $88K |
| 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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.