| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNA LP | THE CURTIS CENTER 601 WALNUT STREET #805 PHILADELPHIA, PA 19106 | INDEPENDENCE BLUE CROSS | $23K | $7K | $31K | 0.90% |
| D. L. MEAD & ASSOCIATES, INC.3 Filed as: D L MEAD & ASSOCIATES INC | 7389 LEE HIGHWAY SUITE 207 FALLS CHURCH, VA 22046 | CAREFIRST | $10K | $2K | $12K | 2.90% |
| TRIBEN INSURANCE SOLUTIONS INC3 | 24 E SECOND ST FL 1 MEDIA, PA 19063 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $0 | $10K | 15.00% |
| TRIBEN INSURANCE SOLUTIONS INC3 | 24 E SECOND ST FL 1 MEDIA, PA 19063 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 10.00% |
| TRIBEN INSURANCE SOLUTIONS INC3 | 24 E SECOND ST FL 1 MEDIA, PA 19063 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNA LP | THE CURTIS CENTER 601 MARKET STREET #805 PHILADELPHIA, PA 19106 | INDEPENDENCE BLUE CROSS | $4K | $2K | $6K | 15.20% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTIONS | 24 EAST 2ND ST, 1ST FL MEDIA, PA 19063 | EYEMED VISION CARE | $3K | $0 | $3K | 9.18% |
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 | 299 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 299 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | INDEPENDENCE BLUE CROSS | 522 | $3.8M |
| Dental | DELTA DENTAL OF PA | 298 | $221K |
| Vision | EYEMED VISION CARE | 664 | $31K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 357 | $121K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 297 | $49K |
| Prescription drug(2 contracts, 2 carriers) | INDEPENDENCE BLUE CROSS | 549 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 664 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.