| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RISK & INSURANCE CONSULTING SERVICE3 | 5500 LILBURN STONE MOUNTAIN RD SUITE B STONE MOUNTAIN, GA 30087 | HCC LIFE INSURANCE COMPANY | $34K | — | $34K | 2.28% |
| J.W. KEMPTON & ASSOCIATES INC3 Filed as: J W KEMPTON ASSOCIATES INC | 13431 N. BROADWAY EXTENSION SUITE 130 OKLAHOMA CITY, OK 73114 | RELIANCE LIFE INSURANCE COMPANY | $27K | — | $27K | 20.00% |
| J.W. KEMPTON & ASSOCIATES INC3 Filed as: J W KEMPTON ASSOCIATES INC | 13431 N. BROADWAY EXTENSION SUITE 130 OKLAHOMA CITY, OK 73114 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $24K | — | $24K | 22.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE KEMPTON COMPANY EIN 73-0977441 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Claims processing; Plan Administrator Service code 12 | — | $4.0M |
| SCRIPTCARE LTD. EIN 76-0621375 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $207K |
| MEDCOM EIN 72-1339762 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $197K |
| MILLIMAN CONSULTANTS AND ACTUARIES EIN 91-0675641 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $135K |
| CAREOPERATIVE LLC EIN 20-8981027 NONE | Other services; Direct payment from the plan Service code 49 | — | $104K |
| HEALTH LAW ADVISORS PLLC EIN 45-2789690 NONE | Legal; Direct payment from the plan Service code 29 | — | $88K |
| HEALTHSMART PREFERRED CARE INC EIN 75-2508316 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $54K |
| FIRST HEALTH GROUP CORP. EIN 20-1736437 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $47K |
| INDEPENDENT BANKERS ASSN. OF TEXAS EIN 75-1459906 NONE | Other services; Direct payment from the plan Service code 49 | — | $40K |
| IBAT SERVICES, INC. EIN 74-2306778 NONE | Direct payment from the plan; Other services Service code 49 | — | $34K |
| PREFERRED COMMUNITY CHOICE PPO EIN 73-1451360 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $31K |
| BKD, LLP EIN 44-0160260 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $29K |
| BANK OF OKLAHOMA EIN 73-0780382 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $20K |
| ADDTRONICS BUSINESS SYSTEMS EIN 73-1597458 NONE | Other services; Direct payment from the plan Service code 49 | — | $19K |
| KEMPTON GROUP ADMINISTRATORS EIN 73-1201547 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $14K |
| FIRST BETHANY BANK EIN 73-0509524 NONE | Other fees; Direct payment from the plan Service code 50 | — | $8K |
| COMMUNITY BANKERS ASSOCIATION EIN 73-0967145 NONE | Other fees; Direct payment from the plan Service code 50 | — | $7K |
| FROST BANK EIN 74-0635455 NONE | Other fees; Direct payment from the plan Service code 50 | — | $5K |
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 | 2,685 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 46 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 2,731 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,484 | $204K |
| Life insurance | RELIANCE LIFE INSURANCE COMPANY | 442 | $133K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,103 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,722 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.