Form 5500 · Employee benefit plan · FORT SMITH, AR
WATER TECH, INC. & AFFILIATES
WATER TECH, INC. & AFFILIATES of FORT SMITH, AR insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is HIGGINBOTHAM INSURANCE AGENCY. Coverage is written through ARKANSAS BLUE CROSS AND BLUE SHIELD and 2 other carriers. The plan's most recent policy period ended in November.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 71-0690640 · plan 502 · plan year 2025, filed Jun 30, 2026
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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.
Benefits declared on this filing
Also declared: death benefits.
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 3 insured contracts covering health, dental, vision, life and disability; the largest, with ARKANSAS BLUE CROSS AND BLUE SHIELD, covers 376 people.
Reported premium across the insured contracts is $1,999,118, with $48,523 in disclosed broker commissions — about 2.4% 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.
HIGGINBOTHAM INSURANCE AGENCY is the broker of record on 2 of the 3 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including ARKANSAS BLUE CROSS AND BLUE SHIELD, UNITED OF OMAHA LIFE INSURANCE COMPANY and USABLE LIFE. ARKANSAS BLUE CROSS AND BLUE SHIELD writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life, Disability | 197 | Dec 1, 2025 | $246,743 | $40,623 |
| USABLE LIFE | — | 125 | Dec 1, 2025 | $39,152 | $7,900 |
| ARKANSAS BLUE CROSS AND BLUE SHIELD | Health, Dental, Vision | 376 | Dec 1, 2025 | $1,713,223 | $0 |
Premium and claims on this contract
ARKANSAS BLUE CROSS AND BLUE SHIELD, contract 026086. For the contract year on this filing, the carrier reported $1,713,223 in premium earned and $2,019,849 in claims incurred. Dividing one by the other gives 118%.
- ARKANSAS BLUE CROSS AND BLUE SHIELD, contract 026086 reported $238,535 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.
How this plan compares
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