| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFITS INC | 3809 WEST CHESTER PIKE STE 190 NEWTOWN SQUARE, PA 19703 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $3K | $6K | 11.50% |
| INDEPENDENCE PLANNING GROUP3 Filed as: INDEPENDENCE PLANNING GROUP, LLC | 1767 SENTRY PKWY WEST BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $33 | — | $33 | 0.07% |
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFITS INC | 3809 WEST CHESTER PIKE STE 190 NEWTOWN SQUARE, PA 19073 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 9.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PATH ADMINISTRATORS EIN 46-1226464 NONE | Contract Administrator; Direct payment from the plan Service code 13 | 4785 LINGLESTOWN ROAD, SUITE 200 HARRISBURG, PA 171120480 | $36K |
| CHARLES J. JOHNSTON EIN 23-2077724 NONE | Legal; Direct payment from the plan Service code 29 | 101 ERFORD ROAD, SUITE 302 CAMP HILL, PA 170010098 | $24K |
| STUYVESANT CAPITAL MANAGEMENT EIN 13-2953844 NONE | Investment management; Direct payment from the plan; Investment advisory (plan) Service code 27 | 200 BUSINESS PARK DRIVE ARMONK, NY 10504 | $14K |
| CREATIVE BENEFITS, INC. EIN 23-2245507 NONE | Other services; Direct payment from the plan; Consulting (general) Service code 16 | 3809 WEST CHESTER PIKE SUITE 190 NEWTOWN SQUARE, PA 19073 | $12K |
| S & S HEALTHCARE STRATEGIES EIN 31-1418743 NONE | Direct payment from the plan; Other services; Insurance services Service code 23 | PO BOX 46511 CINCINNATI, OH 452460511 | $9K |
| ALAN ROSS & COMPANY, PC EIN 20-5367494 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 10 HEARTHSTONE CT, SUITE 100 READING, PA 19606 | $8K |
| FOX ROTHSCHILD LLP EIN 23-1404723 NONE | Legal; Direct payment from the plan Service code 29 | 2000 MARKET STREET, 20TH FL PHILADELPHIA, PA 191033222 | $8K |
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 | 126 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF NORTHEASTERN PENNSYLVANIA | 188 | $257K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 80 | $50K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 134 | $24K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 134 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.