| 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 | $63K | — | $63K | 2.85% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | DELTA DENTAL OF PENNSYLVANIA | $13K | — | $13K | 6.42% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD BERWYN, PA 19312 | STANDARD INSURANCE COMPANY | $23K | — | $23K | 12.99% |
| C2 CENTRIC LLC3 | P.O. BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | $151 | — | $151 | 0.09% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | VISION SERVICE PLAN | $3K | — | $3K | 10.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1 INTERNATIONAL PLAZA, FOURTH FLOOR PHILADELPHIA, PA 19113 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $297 | — | $297 | 1.48% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | AON COMPANY HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $235 | — | $235 | 1.17% |
| EMPLOYEE FAMILY PROTECTION INC3 | PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $108 | — | $108 | 0.54% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO. | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $65 | — | $65 | 0.32% |
| TRION GROUP, INC.3 Filed as: TRION GROUP | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.15% |
| EMERSON REID LLC3 | 1787 SENTRY PARKWAY SUITE 320 BLUE BELL, PA 19422 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.10% |
| BRIAN MALLEY3 | 1543 WICKERTON DRIVE WEST CHESTER, PA 19382 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.07% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO. | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $843 | — | $843 | 11.27% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION, INC. | P.O. BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $287 | — | $287 | 3.84% |
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 | 219 | 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) | 219 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 199 | $2.2M |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 548 | $205K |
| Vision | VISION SERVICE PLAN | 210 | $29K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 245 | $194K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 245 | $194K |
| Long-term disability | STANDARD INSURANCE COMPANY | 245 | $174K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 199 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 548 | — |
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.