| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NORTH AMERICAN BENEFITS COMPANY3 Filed as: NORTH AMERICAN GROUP | P.O. BOX 25928 OKLAHOMA CITY, OK 73125 | AETNA LIFE INSURANCE COMPANY | $37K | $9K | $46K | 2.53% |
| EMPLOYER ADVOCATES LLC3 | 100 PARK AVE., SUITE 700 OKLAHOMA CITY, OK 73102 | AETNA LIFE INSURANCE COMPANY | $3K | — | $3K | 0.18% |
| INSURICA, INC.3 Filed as: INSURICA | 5100 CLASSEN BLVD., SUITE 300 OKLAHOMA CITY, OK 73118 | DELTA DENTAL | $3K | — | $3K | 2.00% |
| PREMIER SOURCE LLC3 | 211 N. ROBINSON AVE., SUITE 1250 OKLAHOMA CITY, OK 73102 | DELTA DENTAL | $2K | — | $2K | 1.66% |
| EMPLOYER ADVOCATES LLC3 | 100 PARK AVE., SUITE 700 OKLAHOMA CITY, OK 73102 | DELTA DENTAL | $499 | — | $499 | 0.34% |
| INSURICA, INC.3 | P.O. BOX 25928 OKLAHOMA CITY, OK 73125 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $160 | $3K | 7.87% |
| PREMIER SOURCE LLC3 | 211 N. ROBINSON AVE., SUITE 1250 OKLAHOMA CITY, OK 73102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $147 | $3K | 7.20% |
| EMPLOYER ADVOCATES LLC3 | 100 PARK AVE., SUITE 700 OKLAHOMA CITY, OK 73130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $274 | — | $274 | 0.64% |
| INSURICA, INC.3 Filed as: INSURICA INC. | P.O. BOX 25928 OKLAHOMA CITY, OK 731250928 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 18.39% |
| PREMIER SOURCE LLC3 | 211 N. ROBINSON AVE., SUITE 1250 OKLAHOMA CITY, OK 731027184 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 17.51% |
| EMPLOYER ADVOCATES LLC3 | 100 PARK AVE OKLAHOMA CITY, OK 731028006 | METROPOLITAN LIFE INSURANCE COMPANY | $273 | — | $273 | 0.89% |
| INSURICA, INC.3 | 5100 N. CLASSEN BLVD., SUITE 300 OKLAHOMA CITY, OK 731185263 | VISION SERVICE PLAN | $608 | — | $608 | 2.61% |
| PREMIER SOURCE LLC3 | 211 N. ROBINSON AVE., SUITE 1250 OKLAHOMA CITY, OK 73102 | VISION SERVICE PLAN | $504 | — | $504 | 2.17% |
| EMPLOYER ADVOCATES LLC3 | 100 PARK AVE., SUITE 700 OKLAHOMA CITY, OK 731028008 | VISION SERVICE PLAN | $104 | — | $104 | 0.45% |
| PREMIERSOURCE LLC3 | 211 N. ROBINSON AVE., SUITE 1250 OKLAHOMA CITY, OK 73102 | GERBER LIFE & ACCIDENT INSURANCE COMPANY | $497 | — | $497 | 7.50% |
| NORTH AMERICAN INSURANCE AGENCY3 Filed as: NORTH AMERICAN INSURANCE AGENCY INC | 5100 N. CLASSEN BLVD., SUITE 300 OKLAHOMA CITY, OK 73118 | GERBER LIFE & ACCIDENT INSURANCE COMPANY | $497 | — | $497 | 7.50% |
| NORTH AMERICAN INSURANCE AGENCY3 Filed as: NORTH AMERICAN INSURANCE AGENCY INC | P.O. BOX 25928 OKLAHOMA CITY, OK 73125 | MHN SERVICES | $76 | — | $76 | 2.51% |
| PREMIERSOURCE LLC3 Filed as: PREMIERSOURCE | 211 N. ROBINSON AVE., SUITE 1250 OKLAHOMA CITY, OK 73102 | MHN SERVICES | $76 | — | $76 | 2.51% |
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 | 182 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 371 | $1.8M |
| Dental | DELTA DENTAL | 174 | $145K |
| Vision | VISION SERVICE PLAN | 173 | $23K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 176 | $31K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 182 | $43K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 182 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 371 | — |
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.