| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL AG | 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS | $26K | — | $26K | 0.52% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PKWY W, VEVA 16, SUITE BLUE BELL, PA 19422 | INDEPENDENCE BLUE CROSS | $22K | — | $22K | 0.45% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTIONS INC. | 24 E SECOND ST, 1ST FLOOR MEDIA, PA 19063 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $47K | — | $47K | 19.76% |
| IMG5 | 2960 N MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $58 | $58 | 0.02% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL AG | 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS | $13K | — | $13K | 22.09% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PKWY W, VEVA 16, SUITE BLUE BELL, PA 19422 | INDEPENDENCE BLUE CROSS | $8K | — | $8K | 13.45% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTIONS | 24 EAST 2ND STREET, FIRST FLOOR MEDIA, PA 19063 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.02% |
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 | 252 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | INDEPENDENCE BLUE CROSS | 588 | $5.1M |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 640 | $0 |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 625 | $29K |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 386 | $240K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 386 | $240K |
| Prescription drug | INDEPENDENCE BLUE CROSS | 588 | $5.0M |
| Other | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 386 | $240K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 640 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.