| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE BENEFIT COMPANY INC3 Filed as: BENEFIT SERVICES, INC. | PO BOX 140790 BROKEN ARROW, OK 74014 | BLUECROSS BLUESHIELD OF OKLAHOMA | $54K | — | $54K | 2.36% |
| THE BENEFIT COMPANY INC3 Filed as: BENEFIT SERVICES, INC. | PO BOX 140790 BROKEN ARROW, OK 74014 | DELTA DENTAL | $4K | — | $4K | 1.94% |
| THE BENEFIT COMPANY INC3 Filed as: BENEFIT SERVICES. INC. | PO BOX 140790 BROKEN ARROW, OK 74014 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $25K | — | $25K | 26.05% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE, STE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $161 | $161 | 0.17% |
| THE BENEFIT COMPANY INC3 Filed as: BENEFIT SERVICES, INC. | PO BOX 140790 BROKEN ARROW, OK 740142728 | VISION SERVICE PLAN | $2K | — | $2K | 4.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRUDENTIAL INSURANCE COMPANY OF AME EIN 22-1211670 NONE | Contract Administrator Service code 13 | — | $8K |
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 | 297 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 297 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF OKLAHOMA | 648 | $2.3M |
| Dental | DELTA DENTAL | 307 | $231K |
| Vision | VISION SERVICE PLAN | 281 | $35K |
| Life insurance(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 406 | $197K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 334 | $95K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 334 | $95K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF OKLAHOMA | 648 | $2.3M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 334 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 648 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.