| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PREMIERSOURCE LLC3 | 211 N. ROBINSON AVE., SUITE 1250 OKLAHOMA CITY, OK 73102 | DELTA DENTAL | $9K | — | $9K | 0.58% |
| EMPLOYER ADVOCATES LLC3 Filed as: EMPLOYER ADVOCATES | 100 PARK AVENUE, SUITE 700 OKLAHOMA CITY, OK 73102 | DELTA DENTAL | $7K | — | $7K | 0.42% |
| PREMIER ADVOCATES LLC3 | 100 PARK AVENUE, SUITE 700 OKLAHOMA CITY, OK 73102 | SUN LIFE ASSURANCE COMPANY OF CANADA | $22K | — | $22K | 1.41% |
| MEDICAL GROUP INSURANCE SERVICES5 Filed as: MEDICAL GROUP INSURANCE SRVCS INC. | 1849 WEST NORTH TEMPLE SALT LAKE CITY, UT 84116 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $255 | $255 | 0.10% |
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 | 1,872 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,876 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MHN SERVICES | 2,194 | $43K |
| Dental | DELTA DENTAL | 1,646 | $1.6M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 3,500 | $200K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,872 | $1.6M |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,872 | $1.6M |
| Long-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,872 | $1.9M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,194 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,500 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.