| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1300 SOUTH MAIN STREET TULSA, OK 74119 | METROPOLITAN LIFE INSURANCE COMPANY | — | $41 | $41 | 0.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | METROPOLITAN LIFE INSURANCE COMPANY | — | $27 | $27 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 400 MIDLAND DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $409 | $409 | 0.60% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $80 | $80 | 0.12% |
| ARVEL J. NAVRATH3 | 305 WEST MAIN STROUD, OK 74079 | AMERICAN FIDELITY ASSURANCE COMPANY | $664 | — | $664 | 9.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 615 EAST BRITTON ROAD OKLAHOMA CITY, OK 73114 | AMERICAN FIDELITY ASSURANCE COMPANY | $437 | — | $437 | 6.40% |
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 | 164 | 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) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 280 | $1.7M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 437 | $72K |
| Vision | EYEMED VISION CARE | 182 | $8K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 222 | $68K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 280 | $1.7M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 222 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 437 | — |
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.