Form 5500 · Employee benefit plan · MCALLEN, TX
CHARLES CLARK CHEVROLET CO.
The filing calls this plan CHARLES CLARK CHEVROLET FLEXI. BENEFITS ACCT PLAN.
Public Form 5500 records show how CHARLES CLARK CHEVROLET CO. of MCALLEN, TX, a retail employer, structures its employee benefits. Its broker of record is FOUNDATION BENEFITS, LLC. Coverage is written through UNITEDHEALTHCARE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 74-0545450 · plan 501 · plan year 2023, filed Sep 9, 2024
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 2 insured contracts covering health, dental and vision; the largest, with UNITEDHEALTHCARE INSURANCE COMPANY, covers 130 people.
Reported premium across the insured contracts is $562,835, with $2,519 in disclosed broker commissions — about 0.4% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
FOUNDATION BENEFITS, LLC is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Two carriers split the book: UNITEDHEALTHCARE INSURANCE COMPANY and AMERITAS LIFE INSURANCE CORP..
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AMERITAS LIFE INSURANCE CORP. | Dental, Vision | 94 | Jan 1, 2024 | $23,531 | $2,519 |
| UNITEDHEALTHCARE INSURANCE COMPANY | Health | 130 | Jan 1, 2024 | $539,304 | $0 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Other plans filed by this employer
How this plan compares
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