| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURICA, INC.3 Filed as: INSURICA INC | P.O. BOX 25928 OKLAHOMA CITY, OK 73125 | AETNA LIFE INSURANCE CO. | $8K | — | $8K | 0.24% |
| INSURICA, INC.3 | 5100 N CLASSEN BLVD STE 300 OKLAHOMA CITY, OK 73118 | DELTA DENTAL OF OKLAHOMA | $0 | — | $0 | 0.00% |
| ASSUREX3 Filed as: ASSUREX AGENCY INC | 175 S 3RD ST STE 800 COLUMBUS, OH 43215 | METROPOLITAN LIFE INSURANCE COMPANY | $371 | — | $371 | 0.95% |
| INSURICA, INC.3 Filed as: INSURICA INC | P.O. BOX 25928 OKLAHOMA CITY, OK 73125 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | — |
| KELLY W PUGH3 | 7367 S 286TH EAST AVE BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | — |
| JOHN F SULLIVAN INC3 Filed as: JOHN F. SULLIVAN INC | DBA SULLIVAN INSURANCE AGENCY P.O. BOX 1534 ARDMORE, OK 73402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | — |
| ALLEN LEE WIEDERSTEIN3 | 10720 CANYON CREST DR EDMOND, OK 73025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | — |
| JAMES POE3 | 11828 SW 3RD TERRACE YUKON, OK 73099 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | — |
| BATES INSURANCE GROUP LLC3 Filed as: BATES INSURANCE GROUP | 519 N 1ST PONCA CITY, OH 74601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $747 | $2 | $749 | — |
| LAINA BATES3 | 6568 E COLEMAN RD PONCA CITY, OK 74604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $380 | $199 | $579 | — |
| SHANNON MARIE BALDWIN3 | 10222 E 114TH ST S BIXBY, OK 74008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $452 | $0 | $452 | — |
| HANNAH NOELLE BATES3 | 6568 E COLEMAN RD PONCA CITY, OK 74604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $329 | $41 | $370 | — |
| HALEY KIRSTEN BATES3 Filed as: HALEY KRISTEN BATES | 6568 E. COLEMAN RD PONKA, OK 74604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $291 | $0 | $291 | — |
| TERRELL JOSEPH THORNE3 | 2060 COUNTY RD 2561 PAWHUSKA, OK 74056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $277 | $0 | $277 | — |
| DAVID EVANS3 | 2711 YORK CT SOUTHLAKE, TX 76092 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $241 | $0 | $241 | — |
| DEBBIE BLACK3 | 4401 ROSS ST AMARILLO, TX 79118 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | — |
| MARILYN K EMBERSON3 | 7220 N HAMMOND AVENUE OKLAHOMA CITY, OK 73132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | — |
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 | 511 | 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) | 511 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 543 | $3.1M |
| Dental | DELTA DENTAL OF OKLAHOMA | 466 | $184K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,033 | $39K |
| Life insurance | AETNA LIFE INSURANCE CO. | 543 | $3.1M |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 127 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,033 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.