| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL AG | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | AETNA LIFE INSURANCE COMPANY | — | $5K | $5K | 0.13% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS | 700 KINDERKAMACK ROAD, SUITE 205 ORADELL, NJ 07675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $308 | $12K | 7.84% |
| KISTLER TIFFANY BENEFITS3 | 400 BERWYN PK, STE 200 BERWYN, PA 19312 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 3.76% |
| EMERSON REID LLC3 | 1787 SENTRY PWKY W, VEVA 16 STE 320 BLUE BELL, PA 19422 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $956 | — | $956 | 0.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SUNNYSIDE BLVD WOODBURY, NY 11797 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $892 | — | $892 | 0.58% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $644 | — | $644 | 0.42% |
| TRAN, THANH, VAN3 | 5409 OLD STAGE RD RALEIGH, NC 27603 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $62 | — | $62 | 0.04% |
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT ROAD SUITE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $1K | $13K | 16.22% |
| ENROLLEASE3 Filed as: ONEDIGITAL PREMIER SERVICES | 899 CASSATT ROAD BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 4.77% |
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $1K | $10K | 16.12% |
| ENROLLEASE3 Filed as: ONEDIGITAL PREMIER SERVICES | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 4.74% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL AG | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $208 | $5K | 10.92% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS LLC | 700 KINDERKAMACK ROAD STE 205 ORADELL, NJ 07675 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $78 | $3K | 10.84% |
| KISTLER TIFFANY BENEFITS3 | 400 BERWYN PARK STE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.69% |
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 | 473 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 473 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 581 | $3.9M |
| Dental | AETNA LIFE INSURANCE COMPANY | 581 | $3.8M |
| Vision | AETNA LIFE INSURANCE COMPANY | 581 | $3.8M |
| Life insurance(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 473 | $279K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 80 | $64K |
| Other(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 473 | $279K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 581 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.