| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT RD STE 200 BERWYN, PA 19312 | HM LIFE INSURANCE COMPANY | $178K | — | $178K | 15.00% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT RD 400 BERWYN PARK, STE 200 BERWYN, PA 19312 | METROPOLITAN LIFE INSURANCE COMPANY | $40K | $7K | $46K | 5.76% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS COMPANY | 400 BERWYN PK STE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $22K | $7K | $29K | 6.98% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS COMPANY | 400 BERWYN PK STE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $5K | $16K | 5.69% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS COMPANY | 400 BERWYN PK STE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $5K | $20K | 7.37% |
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT RD STE 200 BERWYN, PA 19312 | VISION SERVICE PLAN | $3K | — | $3K | 2.17% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS COMPANY | 400 BERWYN PK STE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $2K | $22K | 19.69% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS COMPANY | 400 BERWYN PK STE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $144 | $9K | 14.05% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $274 | $3K | 4.36% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $37 | $2K | 3.97% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS COMPANY | 400 BERWYN PK STE 200 BERWYN, PA 19312 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $1K | $4K | 7.09% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS COMPANY | 400 BERWYN PK STE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $647 | $7K | 19.66% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS COMPANY | 400 BERWYN PK STE 200 BERWYN, PA 19312 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $29 | $5K | 24.81% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $775 | $93 | $868 | 4.46% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $775 | $13 | $788 | 4.05% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS COMPANY | 400 BERWYN PK STE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $304 | $3K | 19.87% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS COMPANY | 400 BERWYN PK STE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $852 | $87 | $939 | 19.60% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS COMPANY | 400 BERWYN PK STE 200 BERWYN, PA 19312 | FIRST UNUM LIFE INSURANCE COMPANY | $116 | — | $116 | 89.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INDEPENDENCE BLUE CROSS EIN 23-0370270 CARRIER | Insurance services Service code 23 | — | $509K |
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 | 1,162 | 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) | 1,162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 2,322 | $802K |
| Vision | VISION SERVICE PLAN | 1,114 | $157K |
| Life insurance(10 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 682 | $1.2M |
| Short-term disability(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 682 | $1.0M |
| Long-term disability(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 682 | $1.0M |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 1,036 | $1.2M |
| Other(11 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 682 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,322 | — |
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.