Form 5500 · Employee benefit plan · SPRINGFIELD, MO
OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY
The filing calls this plan OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN.
OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY of SPRINGFIELD, MO files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is MED-PAY, INC.. Coverage is written through SIRIUSPOINT AMERICA INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in July.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 44-0443840 · plan 501 · plan year 2024, filed Oct 9, 2025
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36 other employer plans in Missouri have policy years ending in July. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Self-funded as reported
The filing reports benefits paid from the plan's own money, and no medical insurance contract on Schedule A.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
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.
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 5 insured contracts covering life, disability and stop-loss; the largest, with SIRIUSPOINT AMERICA INSURANCE COMPANY, covers 751 people.
The filing declares life, disability, health and dental. Health and dental appear with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
The only insured piece of the health benefit is stop-loss coverage, and the filing reports the plan paying its own claims. The 2 stop-loss contracts report $1,451,777 in premium and $179,452 in commission. The rest of the premium and commission above is on the plan's other insured lines, and none of it is medical premium.
Reported premium across the insured contracts is $1,595,998, with $195,476 in disclosed broker commissions — about 12% of premium.
The most recent policy period ended in July, 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 |
|---|---|---|---|---|---|
| SIRIUSPOINT AMERICA INSURANCE COMPANY | Stop-loss | 751 | Aug 1, 2024 | $806,890 | $99,738 |
| SIRIUSPOINT AMERICA INSURANCE COMPANY | Stop-loss | 751 | Jan 1, 2025 | $644,887 | $79,714 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 408 | Jan 1, 2025 | $92,845 | $10,316 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 247 | Jan 1, 2025 | $32,349 | $3,594 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Disability | 751 | Jan 1, 2025 | $19,027 | $2,114 |
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. The service providers are named on Schedule C of this filing. We publish company names only.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
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
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Renewal calendar
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