Form 5500 · Employee benefit plan · SAND SPRINGS, OK
JAMES & MILLER WELDING, LLC
The filing calls this plan JAMES & MILLER WELDING, LLC WELFARE BENEFITS PLAN.
Public Form 5500 records show how JAMES & MILLER WELDING, LLC of SAND SPRINGS, OK, a manufacturing employer, structures its employee benefits. Its broker of record is INSURICA INSURANCE SERVICE, LLC. Coverage is written through BLUECROSS BLUESHIELD OF OKLAHOMA and 2 other carriers. The plan's most recent policy period ended in November.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 26-2039420 · plan 501 · plan year 2025, filed Jun 17, 2026
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
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
Schedule A lists 5 insured contracts covering health, dental and life; the largest, with BLUECROSS BLUESHIELD OF OKLAHOMA, covers 146 people.
Reported premium across the insured contracts is $374,624, with $48,372 in disclosed broker commissions — about 13% of premium.
The most recent policy period ended in November, and the plan year ends November 30. Group contracts typically renew on that annual cycle.
INSURICA INSURANCE SERVICE, LLC is the broker of record on 1 of the 5 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including BLUECROSS BLUESHIELD OF OKLAHOMA, DELTA DENTAL and UNITED OF OMAHA LIFE INSURANCE COMPANY. BLUECROSS BLUESHIELD OF OKLAHOMA writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF OKLAHOMA | Health | 146 | Dec 1, 2025 | $272,516 | $36,380 |
| DELTA DENTAL | Dental | 93 | Dec 1, 2025 | $56,667 | $5,747 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 58 | Dec 1, 2025 | $24,330 | $3,650 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 134 | Dec 1, 2025 | $9,680 | $1,452 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 84 | Dec 1, 2025 | $11,431 | $1,143 |
Premium and claims on this contract
DELTA DENTAL, contract 5747. For the contract year on this filing, the carrier reported $56,667 in premium earned and $43,079 in claims incurred. Dividing one by the other gives 76%.
- DELTA DENTAL, contract 5747 reported $8,154 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.
Other plans filed by this employer
How this plan compares
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