| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 1550 POND ROAD, SUITE 130 ALLENTOWN, PA 18104 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $73K | — | $73K | 3.07% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | DELTA DENTAL OF PENNSYLVANIA | $16K | — | $16K | 7.00% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD BERWYN, PA 19312 | STANDARD INSURANCE COMPANY | $16K | — | $16K | 12.17% |
| C2 CENTRIC LLC3 | P.O. BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | $639 | — | $639 | 0.48% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY | $4K | $492 | $5K | 18.28% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | P.O. BOX 61007 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $337 | — | $337 | 1.43% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | AON COMPANY HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $244 | $85 | $329 | 1.39% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO. | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $174 | $7 | $181 | 0.77% |
| EMPLOYEE FAMILY PROTECTION INC3 | PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $125 | — | $125 | 0.53% |
| EMERSON REID LLC3 | 1787 SENTRY PARKWAY SUITE 320 BLUE BELL, PA 19422 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $48 | — | $48 | 0.20% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.14% |
| BRIAN MALLEY3 | 1543 WICKERTON DRIVE WEST CHESTER, PA 19382 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.07% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION, INC. | P.O. BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $324 | — | $324 | 4.49% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO. | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $119 | $1 | $120 | 1.66% |
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 | 293 | 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) | 293 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 278 | $2.4M |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 661 | $232K |
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 278 | $2.4M |
| Life insurance(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 293 | $182K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 293 | $156K |
| Long-term disability | STANDARD INSURANCE COMPANY | 293 | $132K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 278 | $2.4M |
| Other | UNUM LIFE INSURANCE COMPANY | 19 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 661 | — |
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."
No prospect flags tripped on this filing.