| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT ROAD SUITE 200 BERWYN, PA 19312 | UNITED CONCORDIA INSURANCE COMPANY | $3K | $76 | $3K | 12.20% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 18.88% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $828 | $4K | 17.43% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FINANCIAL SVCS | 1133 WESTCHESTER AVE STE S229 WHITE PLAINS, NY 10604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $537 | $537 | 2.53% |
| KISTLER TIFFANY BENEFITS3 | 899 CASSATT ROAD SUITE 200 BERWYN, PA 19312 | UNITED CONCORDIA DENTAL PLANS OF PENNSYLVANIA, INC. | $487 | $12 | $499 | 11.50% |
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 | 103 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | INDEPENDENCE BLUE CROSS-KEYSTONE | 51 | $700K |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 57 | $31K |
| Vision | INDEPENDENCE BLUE CROSS | 74 | $2K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $26K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $21K |
| Prescription drug | INDEPENDENCE BLUE CROSS-DRUG | 28 | $81K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 103 | — |
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."
No prospect flags tripped on this filing.