| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 | GENERAL AGENCY LLC 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS | $0 | $10K | $10K | 0.25% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $38K | $0 | $38K | 11.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2850 WEST GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $2K | $5K | 1.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BLVD STE 600 GLENDALE, CA 912033944 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $54 | $54 | 0.02% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INS INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303395946 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $12 | $12 | 0.00% |
| KISTLER TIFFANY BENEFITS3 | GENERAL AGENCY LLC 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS | $0 | $2K | $2K | 0.82% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | $0 | $17K | 13.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2850 WEST GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $789 | $2K | 1.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $0 | $11K | 11.48% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INS INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303395946 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.60% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.62% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303395946 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.69% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 11.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2850 WEST GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $242 | $161 | $403 | 1.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4000 MIDLANTIC DRIVE MT. LAUREL, NJ 08054 | KEYSTONE HEALTH PLAN EAST | $458 | $59 | $517 | 2.74% |
| KISTLER TIFFANY BENEFITS3 | GENERAL AGENCY LLC 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | KEYSTONE HEALTH PLAN EAST | $406 | $52 | $458 | 2.43% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | ARAG INSURANCE COMPANY | $832 | $0 | $832 | 9.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & COMPANY | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | ARAG INSURANCE COMPANY | $69 | $0 | $69 | 0.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BFT SVCS INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $677 | $0 | $677 | 10.00% |
| SMITH THOMAS C3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $340 | $0 | $340 | 5.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $80 | $80 | 1.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BFT SVCS INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $645 | $0 | $645 | 12.50% |
| SMITH THOMAS C3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $258 | $0 | $258 | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SVCS INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $61 | $61 | 1.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA BEHAVIORAL HEALTH, LLC NONE | Other services; Contract Administrator Service code 13 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $8K |
| LIFE INSURANCE CO OF NORTH AMERICA EIN 23-1503749 NONE | Contract Administrator Service code 13 | — | $6K |
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 | 476 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 34 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 520 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | INDEPENDENCE BLUE CROSS | 804 | $4.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,308 | $292K |
| Vision | VISION SERVICE PLAN | 302 | $30K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 594 | $343K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 407 | $121K |
| Prescription drug | INDEPENDENCE BLUE CROSS | 154 | $278K |
| Other(6 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 594 | $487K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,308 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.