| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANNY WILLIAM CROSS3 | 516 SUNSET PL CHARLES CITY, IA 50616 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | — | $10K | 20.00% |
| DANNY WILLIAM CROSS3 | 516 SUNSET PL CHARLES CITY, IA 50616 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 20.00% |
| APRIL MARIE HUDGENS3 | PO BOX 450053 GROVE, OK 74345 | AFLAC | $2K | $114 | $2K | 5.51% |
| DEREK J COMAGES3 | 631-5 HC 60 BOX CHECOTAH, OK 74426 | AFLAC | $479 | $23 | $502 | 1.53% |
| MICHAEL ARTHUR KIRK3 | 8401 S 4TH ST BROKEN ARROW, OK 74011 | AFLAC | $357 | — | $357 | 1.09% |
| M JOANNE BLEVINS3 | PO BOX 1436 MIAMI, OK 74355 | AFLAC | $327 | — | $327 | 1.00% |
| GENA GRACE QUARANTELLO3 | 12962 E VISTAPARK DR MOORPARK, CA 93021 | AFLAC | $234 | — | $234 | 0.71% |
| SHIRLEY A BAZAY3 | 5150 BROADWAY ST 156 SAN ANTONIO, TX 78209 | AFLAC | $233 | — | $233 | 0.71% |
| TRAVIS D HURT3 | 18446 S 154TH EAST AVE BIXBY, OK 74008 | AFLAC | $222 | — | $222 | 0.68% |
| JAMES D GRACE3 | 4316 S ASPEN PL BROKEN ARROW, OK 74011 | AFLAC | $189 | $23 | $212 | 0.65% |
| IAGENTTCB LLC3 | 14911 S 4220 RD CLAREMORE, OK 74017 | AFLAC | $155 | — | $155 | 0.47% |
| DARREN R WARREN3 | 13504 N 2320 RD GOTEBO, OK 73041 | AFLAC | $137 | — | $137 | 0.42% |
| JOHN ROBERT DE LARIOS3 | 119 TAMARACK CV HOLLY LAKE RANCH, TX 75765 | AFLAC | $129 | — | $129 | 0.39% |
| LARRY D DENNY3 | PO BOX 306 WETUMKA, OK 74883 | AFLAC | $112 | — | $112 | 0.34% |
| KELLI R CAROTHERS3 | 7310 E 76TH ST TULSA, OK 74133 | AFLAC | $84 | — | $84 | 0.26% |
| LINDA M SMITH3 | PO BOX 451736 GROVE, OK 74345 | AFLAC | $82 | — | $82 | 0.25% |
| ELAINE HAMMAR3 | 7922 S 78TH EAST AVE TULSA, OK 74133 | AFLAC | $60 | — | $60 | 0.18% |
| LYNDA F BENGE3 | 7434 E 83RD PL TULSA, OK 74133 | AFLAC | $57 | — | $57 | 0.17% |
| JOHN N KARR3 | 907 S DETROIT AVE STE 905 TULSA, OK 74120 | AFLAC | $48 | — | $48 | 0.15% |
| LESTER RAY BLACKSHEAR3 | 9192 SE 168TH COOK PL THE VILLAGES, FL 32162 | AFLAC | $33 | — | $33 | 0.10% |
| DAVID L DEARDORFF3 | 1409 SW 21ST TER CAPE CORAL, FL 33991 | AFLAC | $27 | — | $27 | 0.08% |
| LESLIE J BAILEY3 | 4234 N PORTAGE AVE MERIDIAN, ID 83646 | AFLAC | $22 | — | $22 | 0.07% |
| GENA G QUARANTELLO3 | 12962 E VISTAPARK DR MOORPARK, CA 93021 | AFLAC | $18 | — | $18 | 0.05% |
| CARL CLARK3 | 1410 CEDAR ST BARTLESVILLE, OK 74006 | AFLAC | $11 | — | $11 | 0.03% |
| JOHN A WILLIAMS COMPANY INC3 | 20316 N COUNTY ROAD 3240 PAULS VALLEY, OK 73075 | AFLAC | $7 | — | $7 | 0.02% |
| JARRELL K PRENTICE3 | 1113 EAST DR EDMOND, OK 73034 | AFLAC | $7 | — | $7 | 0.02% |
| EDWARD A HALL JR3 | 2224 WOODMARSH CIR AUBURN, GA 30011 | AFLAC | $6 | — | $6 | 0.02% |
| MOFFATT DESIGNS LLC3 | 1221 LAMPLIGHTER LANE EDMOND, OK 73034 | AFLAC | $5 | — | $5 | 0.02% |
| DOUGLAS E FOX3 | 6836 THAYER LAKE DR ALDEN, MI 49612 | AFLAC | $4 | — | $4 | 0.01% |
| SHANE M OWEN3 | 3000 UNITED FOUNDERS BLVD STE 100 OKLAHOMA CITY, OK 73112 | AFLAC | $4 | — | $4 | 0.01% |
| STEPHEN W SIMPSON3 | 540 CELTIC CT EDMOND, OK 73025 | AFLAC | $4 | — | $4 | 0.01% |
| JOSHUA C ROLAN3 | 704 SEMINOLE DR PAULS VALLEY, OK 73075 | AFLAC | $1 | — | $1 | 0.00% |
| JAMES D DUDLEY3 | 1355 LYNNFIELD ST STE 259 MEMPHIS, TN 38119 | AFLAC | $1 | — | $1 | 0.00% |
| PAUL B BROUCHOUD3 | 604 MARK DR DEL CITY, OK 73115 | AFLAC | $1 | — | $1 | 0.00% |
| DANNY WILLIAM CROSS3 | 516 SUNSET PL CHARLES CITY, IA 50616 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CPS INSURANCE SERVICES3 | 4400 MACARTHUR BLVD FL 8 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
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 | 156 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $18K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $67K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 66 | $40K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.