| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | MATTHEW THORNTON HEALTH PLAN, INC. | $7K | — | $7K | 2.05% |
| EMERSON REID LLC3 Filed as: EMERSON REID DBA TRA BENEFIT | STE. 215 EXECUTIVE CAMPUS 630 W. GERMANTOWN PIKE PLYMOUTH MTG, PA 19462 | INDEPENDENCE BLUE CROSS | $14K | — | $14K | 5.80% |
| RITTENHOUSE BENEFITS LLC3 | 1800 JFK BLVD STE 300 PHILADELPHIA, PA 19103 | UNITED HEALTHCARE INSURANCE COMPANY | $103 | $8K | $8K | 4.70% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS COMPANY | 899 CASSATT RD STE 200 400 BERWYN PARK BERWYN, PA 19312 | UNITED HEALTHCARE INSURANCE COMPANY | — | $2K | $2K | 0.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE ITASCA, IL 60143 | GEISINGER QUALITY OPTIONS, INC. | $2K | $15 | $2K | 1.98% |
| KISTLER TIFFANY BENEFITS3 | 400 BERWYN PARK SUITE 200 BERWYN, PA 19312 | GEISINGER QUALITY OPTIONS, INC. | $475 | $25 | $500 | 0.51% |
| MID AMERICA GROUP3 Filed as: MID AMERICA GROUP INC | ONE COMMERCE SQUARE 2005 MARKET ST 7TH FLOOR PHILADELPHIA, PA 19103 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 9.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $807 | $807 | 1.15% |
| ERC OF NY, INC.3 | NO STREET ADDRESS PROVIDED NEW YORK, NY 10016 | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | $3K | — | $3K | 3.98% |
| MID AMERICA GROUP3 Filed as: MID AMERICA GROUP INC | ONE COMMERCE SQUARE 2005 MARKET ST. 7TH FLOOR PHILADELPHIA, PA 19103 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 13.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $144 | $144 | 1.16% |
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 | 169 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | MATTHEW THORNTON HEALTH PLAN, INC. | 174 | $841K |
| Dental | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 213 | $65K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 169 | $70K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 169 | $70K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 169 | $70K |
| Prescription drug | INDEPENDENCE BLUE CROSS | 48 | $250K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 169 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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.