| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA, LP | 125 E. ELM STREET SUITE 210 CONSHOHOCKEN, PA 19428 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $1K | $8K | 16.74% |
| KISTLER TIFFANY BENEFITS3 | 400 BERWYN PARK, STE 200 BERWYN, PA 19312 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $601 | $0 | $601 | 1.19% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA, LP | 125 E. ELM STREET SUITE 210 CONSHOHOCKEN, PA 19428 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $1K | $7K | 16.69% |
| KISTLER TIFFANY BENEFITS3 | 400 BERWYN PARK, STE 200 BERWYN, PA 19312 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $473 | $0 | $473 | 1.21% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA, LP | 125 E. ELM STREET SUITE 210 CONSHOHOCKEN, PA 19428 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $366 | $2K | 16.76% |
| KISTLER TIFFANY BENEFITS3 | 400 BERWYN PARK, STE 200 BERWYN, PA 19312 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $159 | $0 | $159 | 1.36% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA, INC. | 125 E ELM ST, STE 210 CONSHOHOCKEN, PA 19420 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 19.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA, INC. | 125 E ELM ST, STE 210 CONSHOHOCKEN, PA 19420 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 20.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA, INC. | 125 E ELM ST, STE 210 CONSHOHOCKEN, PA 19420 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 20.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA, INC. | 125 E. ELM STREET SUITE 210 CONSHOHOCKEN, PA 19428 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $898 | $226 | $1K | 17.41% |
| KISTLER TIFFANY BENEFITS3 | 400 BERWYN PARK, STE 200 BERWYN, PA 19312 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $70 | $0 | $70 | 1.08% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA, INC. | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19420 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $246 | $7 | $253 | 15.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INDEPENDENCE ADMINISTRATORS (IA) EIN 23-2184623 ADMIN | Claims processing Service code 12 | — | $119K |
| BROWN & BROWN (PA) EIN 20-0878127 BROKER | Insurance agents and brokers Service code 22 | — | $86K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $27K |
| UNITED CONCORDIA COMPANIES, INC EIN 25-1687586 ADMIN | Claims processing Service code 12 | — | $10K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $9K |
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 | 335 | 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) | 335 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 274 | $50K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 86 | $12K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 161 | $39K |
| Stop-loss / reinsurancereinsurance | OPTUM HEALTH (UNIMERICA INSURANCE COMPANY) | 141 | $705K |
| Other(6 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 335 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 335 | — |
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.