| 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 | USABLE LIFE | $16K | — | $16K | 10.99% |
| HORIZON INSURANCE COMPANY5 | 3 PENN PLAZA EAST M2H NEWARK, NJ 07105 | USABLE LIFE | — | $12K | $12K | 8.42% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL AG | 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | DELTA DENTAL OF NJ, INC. | $5K | — | $5K | 4.61% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GEN AGENCY | 400 BERWYN PARK, SUITE 200 899 CASSATT ROAD BERWYN, PA 19312 | EXPRESS SCRIPTS, INC. | $1K | — | $1K | 5.00% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GEN AGENCY | 400 BERWYN PARK, SUITE 200 899 CASSATT ROAD BERWYN, PA 19312 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $1K | — | $1K | 11.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $167K |
| KISTLER TIFFANY BENEFITS GEN AGENCY EIN 84-3134502 BROKER | Other commissions Service code 55 | — | $63K |
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 | 343 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 343 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXPRESS SCRIPTS, INC. | 3 | $20K |
| Dental | DELTA DENTAL OF NJ, INC. | 279 | $99K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 256 | $10K |
| Life insurance | USABLE LIFE | 343 | $146K |
| Short-term disability | USABLE LIFE | 343 | $146K |
| Long-term disability | USABLE LIFE | 343 | $146K |
| Prescription drug | EXPRESS SCRIPTS, INC. | 3 | $20K |
| Other | USABLE LIFE | 343 | $146K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 343 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.