Form 5500 · Employee benefit plan · TULSA, OK
QUIKTRIP CORPORATION
The filing calls this plan QUIKTRIP CORPORATION EMPLOYEE BENEFIT PLAN.
Public Form 5500 records show how QUIKTRIP CORPORATION of TULSA, OK, a retail employer, structures its employee benefits. Its broker of record is HUB INTERNATIONAL MIDWEST LIMITED. Coverage is written through BLUECROSS BLUESHIELD OF OKLAHOMA and 4 other carriers. The plan's most recent policy period ended in April.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 73-0675375 · plan 501 · plan year 2025, filed Sep 22, 2025
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26 other employer plans in Oklahoma have policy years ending in April. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Both, as reported
The medical insurance contracts on the filing cover fewer than half the people in the plan, so the rest is paid another way.
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
Also declared: other welfare.
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 health, dental, vision and life.
The filing declares health, dental, vision, life and disability. Disability appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium across the insured contracts is $28,548,474, with $114,868 in disclosed broker commissions — about 0.4% of premium.
The most recent policy period ended in April, and the plan year ends April 30. Group contracts typically renew on that annual cycle.
HUB INTERNATIONAL MIDWEST LIMITED is the broker of record on 2 of the 5 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. | Health | 839 | May 1, 2025 | $4,913,637 | $106,735 |
| BLUECROSS BLUESHIELD OF OKLAHOMA | Health | 1,392 | May 1, 2025 | $15,669,806 | $8,133 |
| DELTA DENTAL | Dental | 11,319 | May 1, 2025 | $4,604,060 | $0 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Life | 11,973 | May 1, 2025 | $2,916,178 | $0 |
| VISION SERVICE PLAN | Vision | 11,622 | May 1, 2025 | $444,793 | $0 |
Premium and claims on these contracts
BLUECROSS BLUESHIELD OF OKLAHOMA, contract 233119. For the contract year on this filing, the carrier reported $15,669,806 in premium earned and $15,678,024 in claims incurred. Dividing one by the other gives 100%.
DELTA DENTAL, contract 5134. For the contract year on this filing, the carrier reported $4,604,060 in premium earned and $4,330,760 in claims incurred. Dividing one by the other gives 94%.
VISION SERVICE PLAN, contract 01110030. For the contract year on this filing, the carrier reported $444,793 in premium earned and $404,357 in claims incurred. Dividing one by the other gives 91%.
- BLUECROSS BLUESHIELD OF OKLAHOMA, contract 233119 reported $699,695 in retention.
- DELTA DENTAL, contract 5134 reported $399,439 in retention.
- VISION SERVICE PLAN, contract 01110030 reported $40,436 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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Renewal calendar
26 other employer plans in Oklahoma are May 1 renewals (policy year ends April).
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