| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 660 AMERICAN AVE STE 101 KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $893 | — | $893 | 7.99% |
| THE GRAHAM COMPANY3 | 30 SOUTH 15TH ST 23RD FL PHILADELPHIA, PA 19102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $224 | — | $224 | 2.01% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 660 AMERICAN AVE STE 101 KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $593 | — | $593 | 12.21% |
| THE GRAHAM COMPANY3 | 30 SOUTH 15TH ST 23RD FL PHILADELPHIA, PA 19102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $135 | — | $135 | 2.78% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 660 AMERICAN AVE STE 101 KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $140 | — | $140 | 7.95% |
| THE GRAHAM COMPANY3 | 30 SOUTH 15TH ST 23RD FL PHILADELPHIA, PA 19102 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $36 | — | $36 | 2.04% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 660 AMERICAN AVE STE 101 KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF AMERICA | $129 | — | $129 | 7.98% |
| THE GRAHAM COMPANY3 | 30 SOUTH 15TH ST 23RD FL PHILADELPHIA, PA 19102 | LIFE INSURANCE COMPANY OF AMERICA | $32 | — | $32 | 1.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INDEPENDENCE ADMINISTRATORS EIN 23-2184623 ADMINISTRATOR | Claims processing Service code 12 | 1900 MARKET STREET PHILADELPHIA, PA 19103 | $19K |
| TRINITY BENEFIT ADVISORS BROKER | Insurance agents and brokers Service code 22 | 660 AMERICAN AVENUE SUITE 101 KING OF PRUSSIA, PA 19406 | $12K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | 201 E OREGON RD SUITE 100 LITITZ, PA 17543 | $5K |
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 ADMINISTRATOR | Claims processing Service code 12 | ONE DELTA DRIVE MECHANICSBURG, PA 17055 | $2K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | PO BOX 5406 LANCASTER, PA 17606 | $2K |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 145 | $11K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 15 | $2K |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 33 | $6K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 142 | $61K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 145 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 145 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.