Form 5500 · Employee benefit plan · MABELVALE, AR
INTERNATIONAL COMPUTER SYSTEMS, INC.
The filing calls this plan THE ICS, INC. PREMIUM ONLY PLAN.
Public Form 5500 records show how INTERNATIONAL COMPUTER SYSTEMS, INC. of MABELVALE, AR, a finance and insurance employer, structures its employee benefits. Its broker of record is HAWKINS INSURANCE AGENCY. Coverage is written through HEALTH ADVANTAGE and 2 other carriers. The plan's most recent policy period ended in January.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 71-0412268 · plan 505 · plan year 2024, filed Oct 15, 2025
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How this plan is funded
Fully insured as reported
The plan's own financial statement reports paying insurance carriers about what the insurance contracts report in premium.
Benefits declared on this filing
4 contracts on this filing do not say which benefits they cover, so a line above may be insured by one of them.
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.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
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
Schedule A lists 9 insured contracts covering health, dental, vision and life; the largest, with HEALTH ADVANTAGE, covers 107 people.
The filing declares health, dental, vision, life and disability. Disability appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on one of the 4 contracts here that do not say what they cover.
Reported premium across the insured contracts is $802,011, with $12,300 in disclosed broker commissions — about 1.5% of premium.
The health contract's policy period ended in January, while at least one ancillary line's policy period ended in December. The plan is on a split renewal cycle.
HAWKINS INSURANCE AGENCY is the broker of record on all 9 contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| USABLE LIFE | Life | 137 | Jan 1, 2025 | $26,740 | $7,917 |
| USABLE LIFE | — | 45 | Jan 1, 2025 | $7,203 | $1,851 |
| USABLE LIFE | — | 31 | Jan 1, 2025 | $5,541 | $1,198 |
| USABLE LIFE | — | 141 | Jan 1, 2025 | $2,184 | $651 |
| USABLE LIFE | — | 25 | Jan 1, 2025 | $1,563 | $469 |
| USABLE LIFE | Life | 87 | Jan 1, 2025 | $3,054 | $214 |
| HEALTH ADVANTAGE | Health | 107 | Feb 1, 2025 | $683,932 | $0 |
| ARKANSAS BLUE CROSS AND BLUE SHIELD | Dental | 185 | Jan 1, 2025 | $57,312 | $0 |
| ARKANSAS BLUE CROSS AND BLUE SHIELD | Vision | 182 | Jan 1, 2025 | $14,482 | $0 |
Premium and claims on these contracts
HEALTH ADVANTAGE, contract 774859. For the contract year on this filing, the carrier reported $683,932 in premium earned and $470,728 in claims incurred. Dividing one by the other gives 69%.
ARKANSAS BLUE CROSS AND BLUE SHIELD, contract 027273. For the contract year on this filing, the carrier reported $57,312 in premium earned and $35,191 in claims incurred. Dividing one by the other gives 61%.
- HEALTH ADVANTAGE, contract 774859 reported $121,747 in retention.
- ARKANSAS BLUE CROSS AND BLUE SHIELD, contract 027273 reported $12,006 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.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule I
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
Other plans filed by this employer
How this plan compares
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