form5500lookup

Form 5500 · Employee benefit plan · MCLOUD, OK

KICKAPOO TRIBE OF OKLAHOMA

The filing calls this plan KICKAPOO TRIBE OF OKLAHOMA MEDICAL BENEFIT PLAN.

KICKAPOO TRIBE OF OKLAHOMA of MCLOUD, OK is a 606-participant public administration employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is INSURICA, INC.. Coverage is written through BLUECROSS BLUESHIELD OF OKLAHOMA. The plan's most recent policy period ended in September.

Benefits broker of record
INSURICA, INC.
Insurance carrier
BLUECROSS BLUESHIELD OF OKLAHOMA
Policy year ends
Septemberas filed for plan year 2024

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 73-1018494 · plan 504 · plan year 2024, filed Aug 18, 2025

Get an email when this employer files a new Form 5500, and again about four months before its plan renews.

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.

All participants at the start of the year
606
Active at start of year
606
Active at end of year
606
Disclosed commissions
$0
Typical renewal
October 1

Benefits declared on this filing

Healthinsured — BLUECROSS BLUESHIELD OF OKLAHOMA606 of 606 participants (100%)
Dentaldeclared under plan 512
Visiondeclared under plan 508
Lifedeclared under plan 508
Disabilitydeclared under plan 508

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 BLUECROSS BLUESHIELD OF OKLAHOMA, covering 606 people.

Reported premium is $5,370,125; the filing discloses no broker commission on these contracts.

The most recent policy period ended in September, and the plan year ends September 30. Group contracts typically renew on that annual cycle.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
BLUECROSS BLUESHIELD OF OKLAHOMAHealth606Oct 1, 2024$5,370,125$0

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.

See the filing at the Department of Labor

Other plans filed by this employer

Bcbs Medical And Dental Benefits PlanInsured benefit plan · 1 Schedule A contractRenews ~Oct 1Metlife Health And Welfare Benefit PlansInsured benefit plan · 1 Schedule A contractRenews ~Oct 1Metlife Critical Illness Benefit PlanInsured benefit plan · 1 Schedule A contractRenews ~Oct 1Metlife Hospital Indemnity Benefit PlanInsured benefit plan · 1 Schedule A contractRenews ~Oct 1Metlife Accident Benefit PlanInsured benefit plan · 1 Schedule A contractRenews ~Oct 1plan 001Retirement plan · 1 Schedule A contractplan 507Form 5500 filing · no insured Schedule A contractsLife/Ad&D, Std, Ltd Benefits PlanForm 5500 filing · no insured Schedule A contractsVision Benefit PlanForm 5500 filing · no insured Schedule A contractsDelta Dental Benefit PlanForm 5500 filing · no insured Schedule A contracts

How this plan compares

Subscribers see how this compares with similar plans in Oklahoma. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices

Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.

More employer plans in Oklahoma — largest plans, brokers, carriers and renewal months.