| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFITS INC. | 3809 WEST CHESTER PIKE SUITE 190 NEWTOWN SQUARE, PA 19073 | DELTA DENTAL OF NJ, INC. | $39K | — | $39K | 1.92% |
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFITS INC. | 3809 WEST CHESTER PIKE SUITE 190 WEST CHESTER, PA 19073 | SYMETRA LIFE INSURANCE COMPANY | $187K | $24K | $211K | 16.93% |
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFITS INC. | 3809 WEST CHESTER PIKE SUITE 190 NEWTOWN SQUARE, PA 19073 | ANTHEM BLUE CROSS/BLUE SHIELD | $275K | — | $275K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES EIN 35-0781558 ADMINISTRATOR | Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Float revenue Service code 12 | — | $484K |
| CREATIVE BENEFITS, INC. ADMINISTRATOR | Other commissions; Insurance brokerage commissions and fees; Insurance services Service code 23 | 3809 WEST CHESTER PIKE SUITE 190 NEWTOWN SQUARE, PA 19073 | $0 |
| EXPRESS SCRIPTS EIN 23-1714795 ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue Service code 12 | — | $0 |
| INGENIO RX INC. EIN 82-3062245 ADMINISTRATOR | Float revenue; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $0 |
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 | 2,375 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,375 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS/BLUE SHIELD | 2,375 | $0 |
| Dental | DELTA DENTAL OF NJ, INC. | 2,184 | $2.1M |
| Prescription drug | ANTHEM BLUE CROSS/BLUE SHIELD | 2,375 | $0 |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 2,375 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,375 | — |
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.