| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 4622 PENNSYLVANIA AVENUE, SUITE 920 KANSAS CITY, MO 64112 | BLUECROSS BLUESHIELD OF OKLAHOMA | $0 | $5 | $5 | 0.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | BLUECROSS BLUESHIELD OF OKLAHOMA | $0 | $1 | $1 | 0.00% |
| ELIZABETH L. WORTHY3 | PO BOX 1664 DURANT, OK 74702 | AFLAC | $12K | $550 | $12K | 10.42% |
| KEVIN S. RIBERA3 | PO BO 502 BOKCHITO, OK 74726 | AFLAC | $3K | $145 | $3K | 2.79% |
| JOSHUA WORTHY3 Filed as: JOSHUA I. WORTHY | 3700 NORTH CLASSEN BOULEVARD SUITE 220 OKLAHOMA CITY, OK 73118 | AFLAC | $2K | $139 | $2K | 1.96% |
| TONI KAY MILLS3 | 194595 US HIGHWAY 271 ANTLERS, OK 74523 | AFLAC | $2K | $0 | $2K | 1.54% |
| TIMOTHY W WORTHY JR3 Filed as: TIMOTHY WORTHY, JR. & OTHER AGENTS | 2929 WEST MAIN STREET DURANT, OK 74701 | AFLAC | $2K | $0 | $2K | 1.30% |
| BRADLEY JOHN BOS3 | 1809 WEST EVERGREEN STREET DURANT, OK 74701 | AFLAC | $1K | $0 | $1K | 1.19% |
| DAVID E. ESTEP3 | PO BOX 1017 HUGO, OK 74743 | AFLAC | $660 | $40 | $700 | 0.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DEARBORN LIFE INSURANCE COMPANY | $9K | $0 | $9K | 11.08% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | DEARBORN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 3.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1300 SOUTH MAIN STREET TULSA, OK 74119 | DELTA DENTAL OF OKLAHOMA | $3K | $0 | $3K | 6.00% |
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 | 274 | 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) | 274 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF OKLAHOMA | 169 | $1.2M |
| Dental | DELTA DENTAL OF OKLAHOMA | 117 | $52K |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 247 | $78K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 247 | $195K |
| Short-term disability | AFLAC | 162 | $117K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 247 | $78K |
| Prescription drug | BLUECROSS BLUESHIELD OF OKLAHOMA | 169 | $1.2M |
| Other(3 contracts, 3 carriers) | AFLAC | 274 | $199K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 274 | — |
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.