| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL AG | 400 BERWYN PARK SUITE 200 BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS | $6K | $20K | $25K | 1.58% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN METRO LLC | 3330 BARGAINTOWN ROAD EGG HARBOR TWP, NJ 08234 | AETNA LIFE INSURANCE CO | $13K | — | $13K | 15.00% |
| INNOVATIVE RISK SOLUTIONS3 | 3330 BARGAINTOWN RD, STE 2 EGG HARBOR TOWNSHIP, NJ 08234 | AETNA LIFE INSURANCE CO | $0 | — | $0 | 0.00% |
| INNOVATIVE RISK SOLUTIONS3 Filed as: INNOVATIVE RISK SOLUTIONS INC | 3330 BARGAINTOWN RD STE 2 EGG HARBOR TOWNSHIP, NJ 08234 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 18.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 5.58% |
| INNOVATIVE RISK SOLUTIONS3 Filed as: INNOVATIVE RISK SOLUTIONS INC | 3330 BARGAINTOWN RD STE 2 EGG HARBOR TOWNSHIP, NJ 08234 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 6.60% |
| INNOVATIVE RISK SOLUTIONS3 Filed as: INNOVATIVE RISK SOLUTIONS INC | 3330 BARGAINTOWN RD STE 2 EGG HARBOR TOWNSHIP, NJ 08234 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 18.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.93% |
| INNOVATIVE RISK SOLUTIONS3 Filed as: INNOVATIVE RISK SOLUTIONS INC | 3330 BARGAINTOWN RD STE 2 EGG HARBOR TOWNSHIP, NJ 08234 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 18.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $375 | $375 | 6.15% |
No Schedule C service providers reported on this filing.
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 | 226 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INDEPENDENCE BLUE CROSS | 275 | $1.6M |
| Dental | AETNA LIFE INSURANCE CO | 280 | $87K |
| Vision | INDEPENDENCE BLUE CROSS | 275 | $1.6M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 199 | $59K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 199 | $38K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 82 | $42K |
| Prescription drug | INDEPENDENCE BLUE CROSS | 275 | $1.6M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 199 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.