Form 5500 · Employee benefit plan · GREENBRIER, AR
FIRST SERVICE BANK
The filing calls this plan FIRST SERVICE BANK HEALTH PLAN.
FIRST SERVICE BANK of GREENBRIER, AR is a 106-participant finance and insurance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is GALLAGHER BENEFIT SERVICES, INC.. Coverage is written through ARKANSAS BLUE CROSS AND BLUE SHIELD. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 71-0336112 · plan 501 · plan year 2025, filed Aug 19, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
The filing discloses a single insured line, health, through ARKANSAS BLUE CROSS AND BLUE SHIELD, covering 110 people.
Reported premium across the insured contracts is $1,018,710, with $24,985 in disclosed broker commissions — about 2.5% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| ARKANSAS BLUE CROSS AND BLUE SHIELD | Health | 110 | Jan 1, 2026 | $1,018,710 | $24,985 |
Premium and claims on this contract
ARKANSAS BLUE CROSS AND BLUE SHIELD, contract 029513. For the contract year on this filing, the carrier reported $1,018,710 in premium earned and $642,878 in claims incurred. Dividing one by the other gives 63%.
- ARKANSAS BLUE CROSS AND BLUE SHIELD, contract 029513 reported $170,403 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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