| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | HORIZON HEALTHCARE SERVICES, INC. | $52K | — | $52K | 2.46% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ MT DONAHOE & ASSOCIATES LLC | 9755 PATUXENT WOODS DR SUITE 250 COLUMBIA, MD 21046 | HEALTHKEEPERS, INC. | $12K | — | $12K | 3.83% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO. | 2052 ROUTE 35, SUITE 202 WALL, NJ 07719 | DELTA DENTAL OF NJ, INC. | $5K | — | $5K | 3.50% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO. | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | USABLE LIFE | $14K | $10K | $24K | 19.05% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | UNITED AMERICAN | $1K | — | $1K | 7.20% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO. | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | EXPRESS SCRIPTS, INC. | $420 | — | $420 | 3.11% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO. | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | EYEMED VISION CARE | $1K | — | $1K | 10.10% |
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 | 397 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 410 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HORIZON HEALTHCARE SERVICES, INC. | 190 | $2.4M |
| Dental | DELTA DENTAL OF NJ, INC. | 264 | $138K |
| Vision | EYEMED VISION CARE | 349 | $13K |
| Life insurance | USABLE LIFE | 397 | $126K |
| Short-term disability | USABLE LIFE | 397 | $126K |
| Long-term disability | USABLE LIFE | 397 | $126K |
| Prescription drug(2 contracts, 2 carriers) | HORIZON HEALTHCARE SERVICES, INC. | 190 | $2.1M |
| Other | USABLE LIFE | 397 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 397 | — |
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.