| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST UNITED BANK INS. SOLUTIONS3 | PO BOX 6327 MOORE, OK 73160 | COMMUNITY CARE | $0 | $20K | $20K | 1.87% |
| INSURICA, INC.3 Filed as: INSURICA INSURANCE MANAGEMENT | 406 SOUTH BOULDER, SUITE 500 TULSA, OK 74103 | COMMUNITY CARE | — | $19K | $19K | 1.78% |
| INSURICA, INC.3 Filed as: INSURICA INS. MANAGEMENT NETQORK | 406 SOUTH BOULDER, SUITE 500 TULSA, OK 74103 | METROPOLITAIN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 4.94% |
| FIRST UNITED BANK INS. SOLUTIONS3 | PO BOX 6327 MOORE, OK 73160 | METROPOLITAIN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.85% |
| BAINSWEST BENEFITS INC3 Filed as: BAINSWEST BENEFITS, INC. | PO BOX 460 BLACKWELL, OK 74631 | METROPOLITAIN LIFE INSURANCE COMPANY | $39 | $0 | $39 | 0.04% |
| KELLI R CAROTHERS3 Filed as: KELLI R. CAROTHERS | 7310 EAST 76TH STREET TULSA, OK 74133 | AFLAC | $5K | $144 | $6K | 8.00% |
| TAMARA M BEAM3 Filed as: TAMARA M. BEAM | 14106 EAST 492 ROAD CLAREMORE, OK 74019 | AFLAC | $4K | $144 | $4K | 5.45% |
| ELAINE HAMMAR3 Filed as: ELAINE HAMMAR AND OTHER AGENTS | 7922 SOUTH 78TH EAST AVENUE TULSA, OK 74133 | AFLAC | $1K | $40 | $1K | 1.50% |
| JUSTIN W CARROLL3 Filed as: JUSTIN W. CARROLL | 5746 EAST SKELLY DRIVE TULSA, OK 74135 | AFLAC | $993 | $18 | $1K | 1.44% |
| TRAVIS D HURT3 Filed as: TRAVIS D. HURT | 18446 SOUTH 154TH EAST AVENUE BIXBY, OK 74008 | AFLAC | $658 | $18 | $676 | 0.96% |
| JOHN ROBERT DE LARIOS3 | 119 TAMARACK CV HOLLY LAKE RANCH, TX 75765 | AFLAC | $457 | $0 | $457 | 0.65% |
| JAMES D GRACE3 Filed as: JAMES D. GRACE | 2474 WEST NEW ORLEANS STREET BROKEN ARROW, OK 74011 | AFLAC | $204 | $40 | $244 | 0.35% |
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 | 322 | 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) | 322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY CARE | 224 | $1.1M |
| Dental | METROPOLITAIN LIFE INSURANCE COMPANY | 322 | $110K |
| Vision | METROPOLITAIN LIFE INSURANCE COMPANY | 322 | $110K |
| Life insurance | METROPOLITAIN LIFE INSURANCE COMPANY | 322 | $110K |
| Short-term disability | AFLAC | 46 | $70K |
| Prescription drug | COMMUNITY CARE | 224 | $1.1M |
| Other(2 contracts, 2 carriers) | METROPOLITAIN LIFE INSURANCE COMPANY | 322 | $180K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 322 | — |
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."
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.