| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MURRAY INSURANCE ASSOCIATES3 Filed as: MURRAY INSURANCE ASSOCIATES INC | PO BOX 1728 LANCASTER, PA 17608 | STANDARD INSURANCE COMPANY | $37 | $0 | $37 | 1.44% |
| MURRAY INSURANCE ASSOCIATES3 Filed as: MURRAY INSURANCE ASSOCIATES INC | 39 NORTH DUKE STREET LANCASTER, PA 17608 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $257 | $0 | $257 | 22.47% |
| BENECHOICE ENROLLMENT SOLUTIONS & T3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $80 | $3 | $83 | 7.26% |
| PETRINA SKILES3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $11 | $32 | 2.80% |
| LANCE A BRADLEY3 | 2028 MOUNT VERNON CIR HARRISBURG, PA 17110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $0 | $13 | 1.14% |
| ASHLY ELCOCK3 | 200 TATTLETOWN RD AARONSBURG, PA 16820 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.61% |
| JAMES BARTLETT LLC3 | 3138 GREENRIDGE DRIVE LANCSTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.35% |
| CASEY H EBBERT3 | 465 LOCUST RUN DR YORK, PA 17404 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.09% |
| MARY-JOYCE LICATA3 Filed as: MARY J YARNELL | 170 E HAMILTON LN BATTLE CREEK, MI 49015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| MURRAY INS ASSOC INC3 Filed as: MURRAY INSURANCE COMPANY INC | PO BOX 1728 LANCASTER, PA 17608 | STANDARD INSURANCE COMPANY | $8 | $0 | $8 | 1.31% |
| MURRAY INSURANCE ASSOCIATES3 Filed as: MURRAY INSURANCE ASSOCIATES INC | 39 N DUKE ST LANCASTER, PA 17602 | SUN LIFE ASSURANCE COMPANY OF CANADA | $90 | $0 | $90 | 15.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AP BENEFIT ADVISORS, LLC BROKER | Insurance agents and brokers Service code 22 | 772 LITITZ PIKE LANCASTER, PA 17543 | $1K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $904 |
| CAPITAL BLUE CROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $228 |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $198 |
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 | 38 | 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) | 38 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STANDARD INSURANCE COMPANY | 35 | $3K |
| Vision | STANDARD INSURANCE COMPANY | 37 | $611 |
| Life insurance | STANDARD INSURANCE COMPANY | 65 | $0 |
| Short-term disability | STANDARD INSURANCE COMPANY | 65 | $0 |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 65 | $581 |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 38 | $9K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 20 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 65 | — |
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.