Form 5500 · Employee benefit plan · PAMPA, TX
GRAY COUNTY
The filing calls this plan GRAY COUNTY HEALTH BENEFIT PLAN.
GRAY COUNTY of PAMPA, TX is a 106-participant public administration employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is INSURICA. Coverage is written through HCC LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 75-6000966 · plan 501 · plan year 2025, filed Jan 22, 2026
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How this plan is funded
Fully insured as reported
The plan's own financial statement reports paying insurance carriers about what the insurance contracts report in premium.
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 3 insured contracts covering health and life; the largest, with HCC LIFE INSURANCE COMPANY, covers 110 people.
Reported premium across the insured contracts is $457,308, with $3,876 in disclosed broker commissions — about 0.8% of premium.
The most recent policy period ended in September, and the plan year ends September 30. Group contracts typically renew on that annual cycle.
INSURICA is the broker of record on 1 of the 3 contracts; the rest name a different broker or none.
Two carriers split the book: HCC LIFE INSURANCE COMPANY and SUN LIFE ASSURANCE COMPANY OF CANADA.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SUN LIFE ASSURANCE COMPANY OF CANADA | Life | 110 | Oct 1, 2025 | $11,776 | $2,355 |
| HCC LIFE INSURANCE COMPANY | — | 110 | Oct 1, 2025 | $15,208 | $1,521 |
| HCC LIFE INSURANCE COMPANY | Health | 110 | Oct 1, 2025 | $430,324 | $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.
Administrator and service providers
Named on Schedule C of this filing. We publish company names only.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
How this plan compares
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