| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL AG | 400 BERWYN PARK STE 200 899 CASSATT RD BERWYN, PA 19312 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 15.28% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $200 | $200 | 1.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ONEDIGITAL (PHILADELPHIA) EIN 84-3134502 BROKER | Insurance agents and brokers Service code 22 | — | $19K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $11K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVISOR | Other services Service code 49 | — | $2K |
| CAPITAL BLUECROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $2K |
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 | 40 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 41 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 0 | $0 |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 0 | $0 |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 15 | $14K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 15 | $14K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 15 | $14K |
| Stop-loss / reinsurancereinsurance | OPTUM HEALTH (UNIMERICA INSURANCE COMPANY) | 40 | $149K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 15 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 40 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.