| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUGLASS SCHWEGMAN | 300 SHAWNEE BARTLESVILLE, OK 74003 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $576 | — | $576 | — |
| DOUGLAS SCHWEGMAN | 300 S SHAWNEE BARTLESVILLE, OK 74003 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | — | $11K | — |
| VIRGINIA A HAFFENER | 117 OAKHILLS DRIVE COFEYVILLE, KS 67337 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $511 | $3K | — |
| BATES INSURANCE GROUP LLC Filed as: BATES INSURANCE GROUP | PO BOX 2543 PONCA CITY, OK 74602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $846 | $3K | — |
| ANNA CHRISTINE POOLE Filed as: ANNA POOLE | 4800 W 108TH ST 66211 OVERLAND PARK, KS 66211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | — |
| HALEY KIRSTEN BATES | 6568 E COLEMAN RD PONCA CITY, OK 74602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $994 | $100 | $1K | — |
| RON BOWLING Filed as: RON BOWING | 8575 W 110TH ST OVERLAND PARK, KS 66210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $440 | $378 | $818 | — |
| ANDREA DARLENE KRAMER Filed as: ANDREA KRAMER | 20872 S LAUREL STREET CLAREMORE, OK 74019 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $608 | — | $608 | — |
| DALE E WASHBURN Filed as: DALE WASHBURN | 133 POINT SEVEN RD KIMBERLING CITY, MO 65686 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $472 | — | $472 | — |
| MELISSA ANNE SCHWEGMAN | 300 S SHAWNEE BARTLESVILLE, OK 74003 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $209 | $85 | $294 | — |
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 | 158 | 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) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 158 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.