| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL | 400 BERWYN PARK STE 200 899 CASSATT RD BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $213 | $1K | 12.56% |
| ENROLLEASE3 Filed as: ONEDIGITAL PREMIER SERVICES | 400 BERWYN PARK STE 200 899 CASSATT ROAD BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $532 | $532 | 4.66% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 3100 CUMBERLAND BLVD STE1700 ATLANTA, GA 30339 | DELTA DENTAL OF PENNSYLVANIA | $1K | $0 | $1K | 10.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $568 | $76 | $644 | 15.56% |
| ENROLLEASE3 Filed as: ONEDIGITAL PREMIER SERVICES | 400 BERWYN PARK STE 200 899 CASSATT ROAD BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $189 | $189 | 4.57% |
| KISTLER TIFFANY BENEFITS3 | 1550 POND RD SUITE 130 ALLENTOWN, PA 18104 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $102 | $0 | $102 | 4.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ONEDIGITAL (PHILADELPHIA) EIN 84-3134502 BROKER | Insurance agents and brokers Service code 22 | — | $9K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $7K |
| CAPITAL BLUECROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $2K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $1K |
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 | 28 | 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) | 28 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 35 | $11K |
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 39 | $3K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 28 | $11K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 28 | $11K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 28 | $11K |
| Stop-loss / reinsurancereinsurance | OPTUM HEALTH (UNIMERICA INSURANCE COMPANY) | 18 | $126K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 28 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 39 | — |
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.