| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONNER STRONG & BUCKELEW3 | 401 ROUTE 73 NORTH P.O. BOX 989 MARLTON, NJ 08053 | HARTFORD LIFE AND ACCIDENT | $7K | $7K | $15K | 5.02% |
| VIST INSURANCE LLC3 | 1240 BROADCASTING ROAD P.O. BOX 6707 WYOMISSING, PA 19610 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 17.21% |
| TOMPKINS INSURANCE AGENCIES3 Filed as: TOMPKINS INS. AGENCIES INC. | 90 MAIN STREET BATAVIA, NY 14020 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.05% |
| VIST INSURANCE LLC3 | 1240 BROADCASTING ROAD P.O. BOX 6707 WYOMISSING, PA 19610 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 12.43% |
| TOMPKINS INSURANCE AGENCIES3 Filed as: TOMPKINS INS. AGENCIES INC. | 90 MAIN STREET BATAVIA, NY 14020 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $410 | $2K | 7.93% |
| HARRIS S. FISHMAN3 | 2 BALA PLAZA SUITE 901 BALA CYNWYD, PA 190041501 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $253 | — | $253 | 1.94% |
| VIST INSURANCE LLC3 | 1240 BROADCASTING ROAD P.O. BOX 6707 WYOMISSING, PA 19610 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $654 | — | $654 | 13.48% |
| TOMPKINS INSURANCE AGENCIES3 Filed as: TOMPKINS INS. AGENCIES INC. | 90 MAIN STREET BATAVIA, NY 14020 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $232 | $96 | $328 | 6.76% |
| VIST INSURANCE LLC3 | 1240 BROADCASTING ROAD P.O. BOX 6707 WYOMISSING, PA 19610 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $112 | — | $112 | 16.69% |
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 | 294 | 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) | 294 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Long-term disability(6 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 294 | $376K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 294 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.