| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC DBA COURY HEALTH SV | 965 GREENTREE RD STE 310 PITTSBURGH, PA 15220 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $92 | $0 | $92 | 10.02% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC DBA COURY HEALTH SV | 965 GREENTREE RD STE 310 PITTSBURGH, PA 15220 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $40 | $0 | $40 | 9.90% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC DBA COURY HEALTH SR | 965 GREENTREE RD STE310 PITTSBURGH, PA 15222 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $32 | $0 | $32 | 9.94% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC DBA COURY HEALTH SV | 965 GREENTREE RD STE 310 PITTSBURGH, PA 15220 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $21 | $0 | $21 | 9.81% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC DBA COURY HEALTH SV | 965 GREENTREE RD STE 310 PITTSBURGH, PA 15220 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $25 | $0 | $25 | 14.79% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP | 965 GREENTREE RD STE 310 PITTSBURGH, PA 15220 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $24 | $0 | $24 | 15.00% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC DBA COURY HEALTH SV | 965 GREENTREE RD STE 310 PITTSBURGH, PA 15220 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13 | $0 | $13 | 10.32% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COURY HEALTH SERVICES, LLC EIN 25-1692664 BROKER | Insurance agents and brokers Service code 22 | — | $600 |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $476 |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $104 |
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 | UNITED OF OMAHA LIFE INSURANCE COMPANY | 21 | $918 |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 19 | $214 |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $126 |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $404 |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 23 | $6K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $777 |
| 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.