| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NHUNG LE PHAN3 | 102 LIBERTY AVENUE ATLANTIC CITY, NJ 08401 | KANSAS CITY LIFE INSURANCE COMPANY | $7K | $0 | $7K | 8.35% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: MURRAY RISK MANAGEMENT | 30 NORTH DUKE STREET LANCASTER, PA 17602 | KANSAS CITY LIFE INSURANCE COMPANY | $5K | $0 | $5K | 5.38% |
| EMERSON REID LLC3 Filed as: EMERSON REID & COMPANY, INC | 669 RIVER DRIVE CENTER, SUITE 305 ELMWOOD PARK, NJ 07407 | KANSAS CITY LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.39% |
| MURRAY INSURANCE ASSOCIATES3 Filed as: MURRAY INSURANCE ASSOCIATES INC. | 39 NORTH DUKE STREET LANCASTER, PA 17602 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 9.38% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $98 | $98 | 0.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 ADMIN | Claims processing Service code 12 | — | $11K |
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 | 275 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 275 | $36K |
| Short-term disability | KANSAS CITY LIFE INSURANCE COMPANY | 139 | $86K |
| Long-term disability | KANSAS CITY LIFE INSURANCE COMPANY | 139 | $86K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 275 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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.