| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NORTH AMERICAN INSURANCE AGENCY3 | PO BOX 949 LAWTON, OK 735020949 | BLUECROSS BLUESHIELD OF OKLAHOMA | $68K | — | $68K | 4.09% |
| INSURICA, INC.3 Filed as: INSURICA INSURANCE MANAGEMENT | 5100 N CLASSEN BLVD STE 300 OKLAHOMA CITY, OK 73118 | BLUECROSS BLUESHIELD OF OKLAHOMA | — | $3K | $3K | 0.18% |
| NORTH AMERICAN INSURANCE AGENCY3 | PO BOX 949 LAWTON, OK 735020949 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 6.56% |
| NORTH AMERICAN INSURANCE AGENCY3 | 10 SW 2ND ST, STE 1 LAWTON, OK 73501 | DELTA DENTAL | $6K | — | $6K | 8.00% |
| NORTH AMERICAN INSURANCE AGENCY3 | PO BOX 949 LAWTON, OK 735020949 | VISION SERVICE PLAN | $2K | — | $2K | 3.91% |
| NORTH AMERICAN BENEFITS COMPANY3 Filed as: NORTH AMERICAN INSURANCE | PO BOX 949 LAWTON, OK 73502 | PRINCIPAL LIFE INSURANCE COMPANY | $187 | — | $187 | 7.15% |
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 | 321 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF OKLAHOMA | 404 | $1.7M |
| Dental | DELTA DENTAL | 319 | $78K |
| Vision | VISION SERVICE PLAN | 321 | $41K |
| Life insurance(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 401 | $91K |
| Short-term disability(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 401 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 404 | — |
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.