| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLS | 24 E 2ND ST 1ST FL MEDIA, PA 19063 | DELTA DENTAL OF PENNSYLVANIA | $3K | $0 | $3K | 5.00% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTION | 24 E 2ND ST 1ST FL MEDIA, PA 19063 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $1K | $4K | 20.19% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTION | 24 E 2ND ST 1ST FL MEDIA, PA 19063 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $717 | $3K | 19.67% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTION | 24 E 2ND ST 1ST FL MEDIA, PA 19063 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $644 | $2K | 21.12% |
| TRIBEN INSURANCE SOLUTIONS INC3 | 24 E 2ND STREET MEDIA, PA 19063 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $753 | $0 | $753 | 10.24% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTIONS | 24 E 2ND STREET MEDIA, PA 19063 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $25 | $0 | $25 | 0.34% |
| TRIBEN INSURANCE SOLUTIONS INC3 | 24 E 2ND STREET MEDIA, PA 19063 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $520 | $0 | $520 | 10.83% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTIONS | 24 E 2ND STREET MEDIA, PA 19063 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $70 | $0 | $70 | 1.46% |
| TRIBEN INSURANCE SOLUTIONS INC3 | 24 E 2ND STREET MEDIA, PA 19063 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $387 | $0 | $387 | 10.04% |
| TRIBEN INSURANCE SOLUTIONS INC3 | 24 E 2ND STREET MEDIA, PA 19063 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $218 | $0 | $218 | 6.93% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTIONS | 24 E 2ND STREET MEDIA, PA 19063 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $33 | $0 | $33 | 1.05% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTION | 24 E 2ND ST 1ST FL MEDIA, PA 19063 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $184 | $55 | $239 | 19.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC. EIN 35-1450364 NONE | Claims processing; Contract Administrator Service code 12 | — | $35K |
| GREAT WEST HEALTHCARE/ CIGNA EIN 84-0467907 NONE | Named fiduciary; Direct payment from the plan; Contract Administrator; Non-monetary compensation; Claims processing; Float revenue; Other services; Participant communication Service code 12 | — | $22K |
| AMERICAN HEALTH DATA INSTITUTE EIN 35-2048379 NONE | Other services; Consulting (general); Other fees Service code 16 | — | $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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 114 | $282K |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 193 | $53K |
| Vision | VISION BENEFITS OF AMERICA | 111 | $12K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 166 | $11K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 64 | $22K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 54 | $15K |
| Stop-loss / reinsurancereinsurance | AMERICAN FIDELITY ASSURANCE COMPANY | 114 | $263K |
| Other(6 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 166 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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.
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.