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) | 90 DEGREE BENEFITS SYSTEM | 33 | $194K |
| Dental | PREMIER ACCESS INSURANCE DENTAL COVERAGE | 34 | $19K |
| Vision | PREMIER ACCESS INSURANCE VISION COVERAGE | 28 | $4K |
| Life insurance(2 contracts, 2 carriers) | GILSBAR LIFE INSURANCE COVERAGE | 34 | $2K |
| 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 | MORGAN WHITE GROUP PROGRAMS-GAP FIDELITY PLAN | 29 | $36K |
| 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."
No prospect flags tripped on this filing.