| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 8.91% |
| AMERIHEALTH ADMINISTRATORS INC3 Filed as: AMERIHEALTH ADMINISTRATORS | P.O. BOX 21545 EAGAN, MN 55121 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $24 | — | $24 | 0.04% |
| WILLIAM O DAGGETT JR3 Filed as: WILLIAM O DAGGETT III | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 9.14% |
| WILLIAM O DAGGETT JR3 | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $890 | $495 | $1K | 4.74% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $787 | $787 | 2.70% |
| NORTH AMERICAN BENEFITS COMPANY5 Filed as: NORTH AMERICAN BENEFITS CO | 20 VALLEY STREAM PARKWAY, SUITE 310 MALVERN, PA 19355 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $583 | — | $583 | 10.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $73K |
| KISTLER TIFFANY BENEFITS CO EIN 23-3021992 BROKER | Other commissions Service code 55 | — | $34K |
| JAMES A SCOTT & SON, INC. EIN 54-0372970 BROKER | Other commissions Service code 55 | — | $5K |
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 | 137 | 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) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 137 | $55K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 252 | $6K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 137 | $55K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 137 | $84K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 137 | $29K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 136 | $212K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 137 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 252 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.