| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UMR, INC.3 Filed as: UMR | 11 SCOTT STREET WAUSAU, WI 54403 | ZURICH NORTH AMERICAN INSURANCE COMPANY | — | $5K | $5K | 3.00% |
| APRIL MARIE HUDGENS3 Filed as: APRIL MARIE HALL | P.O. BOX 450053 GROVE, OK 74345 | AFLAC | $2K | $101 | $2K | 3.18% |
| M JOANNE BLEVINS3 | P.O. BOX 1436 MIAMI, OK 74355 | AFLAC | $1K | — | $1K | 1.97% |
| MICHAEL ARTHUR KIRK3 Filed as: MICHAEL KIRK | 1913 W TACOMA STREET, SUITE C BROKEN ARROW, OK 74012 | AFLAC | $730 | — | $730 | 1.25% |
| TRAVIS D HURT3 | 5746 E. SKELLY DRIVE TULSA, OK 74135 | AFLAC | $710 | — | $710 | 1.22% |
| GENA G QUARANTELLO3 | 12371 SHORELINE DRIVE SPERRY, OK 74073 | AFLAC | $463 | — | $463 | 0.79% |
| SHIRLEY A BAZAY3 | 2941 MOSSROCK 205 SAN ANTONIO, TX 78230 | AFLAC | $460 | — | $460 | 0.79% |
| JOHN ROBERT DE LARIOS3 | 4306 W. TOLEDO CT BROKEN ARROW, OK 74012 | AFLAC | $428 | $20 | $448 | 0.77% |
| IAGENTTCB LLC3 | 14911 S. 4220 ROAD CLAREMORE, OK 74017 | AFLAC | $401 | — | $401 | 0.69% |
| DARREN R WARREN3 | 13504 NORTH 2320 ROAD GOTEBO, OK 73041 | AFLAC | $370 | — | $370 | 0.63% |
| DEREK J COMAGES3 Filed as: DEREK J. COMAGES | 631-5 HC 60 BOX CHECOTAH, OK 74426 | AFLAC | $276 | $20 | $296 | 0.51% |
| LARRY D DENNY3 | P.O. BOX 306 WETUMKA, OK 74883 | AFLAC | $269 | — | $269 | 0.46% |
| LYNDA F BENGE3 | 7434 E. 83RD PLACE TULSA, OK 74133 | AFLAC | $162 | — | $162 | 0.28% |
| KELLI R CAROTHERS3 | 7310 E. 76TH STREET TULSA, OK 74133 | AFLAC | $122 | — | $122 | 0.21% |
| LINDA M SMITH3 | P.O. BOX 451736 GROVE, OK 74345 | AFLAC | $119 | — | $119 | 0.20% |
| JOHN A WILLIAMS COMPANY INC3 | 3100 S. BERRY ROAD, SUITE 100 NORMAN, OK 73072 | AFLAC | $99 | $20 | $119 | 0.20% |
| ELAINE HAMMAR3 | 7922 S. 78TH E. AVENUE TULSA, OK 74133 | AFLAC | $80 | — | $80 | 0.14% |
| LESTER RAY BLACKSHEAR3 | 500 E. FORT KING STREET, SUITE A OCALA, FL 34471 | AFLAC | $59 | — | $59 | 0.10% |
| LESLIE J BAILEY3 Filed as: LESLIE J. BAILEY | 4234 N. PORTAGE AVENUE MERIDIAN, ID 83646 | AFLAC | $57 | — | $57 | 0.10% |
| DAVID L DEARDORFF3 | 9083 E. 138TH STREET S. BIXBY, OK 74008 | AFLAC | $41 | — | $41 | 0.07% |
| CARL CLARK3 | 410 JANET STREET TAHLEQUAH, OK 74464 | AFLAC | $30 | — | $30 | 0.05% |
| DOUGLAS E FOX3 | 735 S. GARFIELD AVENUE, SUITE 203 TRAVERSE CITY, MI 49686 | AFLAC | $7 | — | $7 | 0.01% |
| SARAH J HALL3 | 23544 FLOYD MOORE ROAD GENTRY, AR 72734 | AFLAC | — | — | $0 | 0.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 600 KANSAS CITY, MO 64112 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $140 | $1K | 7.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $91K |
| SCRIPT CARE, LTD EIN 76-0621375 RX ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $9K |
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 | 168 | 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) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 313 | $18K |
| Stop-loss / reinsurancereinsurance | ZURICH NORTH AMERICAN INSURANCE COMPANY | 158 | $177K |
| Other(2 contracts, 2 carriers) | AFLAC | 313 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 313 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.