| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POMEROY & ASSOCIATES LLC | 3134 NORTH SEVENTH STREET SUITE 1 PHOENIX, AZ 85014 | NATIONWIDE LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| POMEROY & ASSOCIATES LLC Filed as: POMEROY, THOMAS ROBERT | 3134 N 7TH ST PHOENIX, AZ 85014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 4.64% |
| POMEROY & ASSOCIATES LLC3 | 3134 N 7TH ST PHOENIX, AZ 85014 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | — | $9K | 20.00% |
| POMEROY & ASSOCIATES LLC3 | 3134 N 7TH ST PHOENIX, AZ 85014 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 20.00% |
| POMEROY & ASSOCIATES LLC3 | 3134 N 7TH ST PHOENIX, AZ 85014 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 20.00% |
| POMEROY & ASSOCIATES LLC | 3134 N 7TH ST PHOENIX, AZ 850145431 | NATIONAL GUARDIAN LIFE | $2K | — | $2K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MAXOR ADMINISTRATIVE SERVICES EIN 37-1692805 THIRD PARTY ADMINISTRATOR | Plan Administrator Service code 14 | 320 SOUTH POLK STREET SUITE 700 AMARILLO, TX 79101 | $103K |
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 | 514 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 514 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | NATIONAL GUARDIAN LIFE | 126 | $21K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 301 | $33K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 299 | $46K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 299 | $35K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE LIFE INSURANCE COMPANY | 510 | $790K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 301 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 510 | — |
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.