| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: GUNN MOWERY LLC | — | UNITED CONCORDIA INSURANCE COMPANY | $150 | $0 | $150 | 10.02% |
| MOWERY ASSOCIATES3 Filed as: MOWERY, THEODORE | 650 N 12TH ST LEMOYNE, PA 17043 | HIGHMARK, INC. | $18 | $0 | $18 | 6.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GUNN MOWERY EIN 81-0587373 BROKER | Insurance agents and brokers Service code 22 | — | $1K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $900 |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $197 |
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 | 35 | 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) | 35 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 45 | $1K |
| Vision | HIGHMARK, INC. | 51 | $272 |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2 | $829 |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2 | $829 |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 36 | $14K |
| Other | HARTFORD LIFE AND ACCIDENT | 2 | $829 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 51 | — |
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.