| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS LLC | 700 KINDERKAMACK ROAD, SUITE 205 ORADELL, NC 07675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16K | $0 | $16K | 11.09% |
| KISTLER TIFFANY BENEFITS3 | 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $0 | $8K | 5.66% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | SUITE 320 1787 SENTRY PARKWAY, VEVA 16 BLUE BELL, PA 19422 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $872 | $0 | $872 | 0.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | NORTHEAST LIMITED 100 SUNNYSIDE BLVD. WOODBURY, NY 11797 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $826 | $0 | $826 | 0.56% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | AN AON COMPANY 1 N WHITE HORSE PIKE #2 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $606 | $0 | $606 | 0.41% |
| THANH TRAN3 | 5409 OLD STAGE ROAD RALEIGH, NC 27603 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $57 | $0 | $57 | 0.04% |
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT ROAD SUITE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $2K | $14K | 18.18% |
| ENROLLEASE3 Filed as: ONEDIGITAL PREMIER SERVICES | 899 CASSATT ROAD BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $4K | $4K | 5.35% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL AG | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $132 | $6K | 10.11% |
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $1K | $11K | 18.28% |
| ENROLLEASE3 Filed as: ONEDIGITAL PREMIER SERVICES | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 5.38% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS LLC | 700 KINDERKAMACK ROAD STE 205 ORADELL, NJ 07675 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 16.37% |
| KISTLER TIFFANY BENEFITS3 | 400 BERWYN PARK STE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 8.81% |
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 | 503 | 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) | 503 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 407 | $1.2M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 320 | $202K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 320 | $187K |
| Life insurance(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 503 | $282K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 441 | $148K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 76 | $58K |
| Other(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 503 | $282K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 503 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.