No brokers reported on this filing.
No Schedule C service providers reported on this filing.
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 | 34 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 34 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ALLIED/90 DEGREE BENEFITS SYSTEM | 29 | $220K |
| Dental | PREMIER ACCESS INSURANCE DENTAL COVERAGE | 32 | $19K |
| Vision | PREMIER ACCESS INSURANCE VISION COVERAGE | 32 | $6K |
| Life insurance(3 contracts, 3 carriers) | AMERICAN HERITAGE LIFE INSURANCE | 34 | $8K |
| Short-term disability | UNUM LIFE INSURANCE-ACCIDENTAL DEATH/DISMEMBERMENT & LIFE COVERAGE | 34 | $1K |
| Long-term disability | UNUM LIFE INSURANCE-ACCIDENTAL DEATH/DISMEMBERMENT & LIFE COVERAGE | 34 | $1K |
| Other | UNITED GROUP/MORGAN WHITE GROUP PROGRAMS-GAP FIDELITY PLAN | 29 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 34 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.