| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYCOM PAYROLL LLC3 Filed as: PAYCOM PAYROLL HOLDINGS LLC | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | STANDARD INSURANCE COMPANY | $0 | -$831 | -$831 | -3.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | $512 | $5K | 26.41% |
| SUMMIT FINANCIAL GROUP INC.3 Filed as: SUMMIT FINANCIAL GROUP INC | 5420 LBJ FWY STE 1940 DALLAS, TX 75240 | SUN LIFE ASSURANCE COMPANY OF CANADA | $260 | $0 | $260 | 1.50% |
| PAYCOM PAYROLL LLC3 Filed as: PAYCOM PAYROLL HOLDINGS LLC | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | STANDARD INSURANCE COMPANY | $0 | -$586 | -$586 | -3.70% |
| PAYCOM PAYROLL LLC3 Filed as: PAYCOM PAYROLL HOLDINGS LLC | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | STANDARD INSURANCE COMPANY | $0 | -$514 | -$514 | -3.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 615 E. BRITTON RD OKLAHOMA CITY, OK 73114 | TRANSAMERICA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 33.29% |
| SUMMIT FINANCIAL GROUP INC.3 Filed as: SUMMIT FINANCIAL GROUP INC | 1350 S BOULDER SUITE 300 TULSA, OK 74119 | TRANSAMERICA LIFE INSURANCE COMPANY | $139 | $0 | $139 | 2.30% |
| INTERMEDIARY SOLUTIONS COMPANY4 | 5 SAWGRASS CT FRISCO, TX 75034 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $154 | $0 | $154 | 10.03% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: ARTHUR J GALLAGHER | 2850 GOLF RD 5TH FL ROLLING MEADOWS, IL 60008 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $101 | $0 | $101 | 6.58% |
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 | 152 | 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) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 120 | $93K |
| Vision | VISION SERVICE PLAN | 107 | $14K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 159 | $28K |
| Short-term disability | STANDARD INSURANCE COMPANY | 51 | $15K |
| Long-term disability | STANDARD INSURANCE COMPANY | 39 | $16K |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 159 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.