| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MURRAY INSURANCE ASSOCIATES3 Filed as: MURRAY INSURANCE ASSOCIATES INC | 39 DUKE ST LANCASTER, PA 17602 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $613 | $0 | $613 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASSURED PARTNERS (CENTRAL PA) EIN 30-0837157 BROKER | Insurance agents and brokers Service code 22 | — | $792 |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $662 |
| CAPITAL BLUECROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $144 |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $131 |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 24 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 24 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PCI (PA CHAMBER INSURANCE) | 0 | $0 |
| Vision | PCI (PA CHAMBER INSURANCE) | 0 | $0 |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 6 | $6K |
| Short-term disability | AFLAC (CONTINENTAL AMERICAN INSURANCE COMPANY) | 0 | $0 |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 24 | $8K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 6 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 24 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.