| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENER | 413 MARLTON PIKE EAST SUITE 300 CHERRY HILL, NJ 08034 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 0.82% |
| ENROLLEASE3 Filed as: ONE DIGITAL PREMIER SERVICES LLC | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
| WORLD INSURANCE ASSOCIATES LLC3 | PO BOX 95000 PHILADELPHIA, PA 19195 | DENTAL SERVICES ORGANIZATION | $0 | $0 | $0 | 0.00% |
| ENROLLEASE3 Filed as: ONE DIGITAL PREMIER SERVICES LLC | 400 BERWYN PARK STE 200 BERWYN, PA 19312 | METROPOLITAN INSURANCE COMPANY | $0 | $0 | $0 | — |
| ADVANCED BENEFIT CONCEPTS OF CHERRY3 | 413 MARLTON PIKE E STE 300 CHERRY HILL, NJ 08034 | METROPOLITAN INSURANCE COMPANY | $0 | $0 | $0 | — |
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT RD 400 BERWYN PK STE 20 BERWYN, PA 19312 | METROPOLITAN INSURANCE COMPANY | $0 | $0 | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRIADA HEALTH LLC EIN 82-5371810 THIRD PARTY ADMINISTRATOR | Plan Administrator Service code 14 | 15814 CHAMPION FOREST DR SUITE 260 SPRING, TX 77379 | $51K |
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 | 305 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 305 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 305 | $230K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 305 | $215K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 305 | $215K |
| Short-term disability | METROPOLITAN INSURANCE COMPANY | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 305 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.