| 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 | $42 | $7K | $7K | 0.14% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INS INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303395946 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $13 | $13 | 0.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $39K | $0 | $39K | 11.00% |
| KISTLER TIFFANY BENEFITS3 | GENERAL AGENCY LLC 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS | $0 | $1K | $1K | 0.52% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18K | $0 | $18K | 13.63% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INS INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $1K | $10K | 8.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.35% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.13% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303395946 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.58% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN RD STE 300 BETHESDA, MD 208142554 | VISION SERVICE PLAN | $83 | $0 | $83 | 0.26% |
| 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 | 10.95% |
| KISTLER TIFFANY BENEFITS3 | GENERAL AGENCY LLC 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS | $2K | $0 | $2K | 12.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | ARAG INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA BEHAVIORAL HEALTH, LLC NONE | Other services; Contract Administrator Service code 13 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $9K |
| 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 | 500 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 16 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 526 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | INDEPENDENCE BLUE CROSS | 875 | $4.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,348 | $411K |
| Vision | VISION SERVICE PLAN | 326 | $32K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 622 | $352K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 432 | $132K |
| Prescription drug | INDEPENDENCE BLUE CROSS | 162 | $280K |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 622 | $511K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,348 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.