| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CREATIVE BENEFITS, INC.3 | 3809 WEST CHESTER PIKE SUITE 190 NEWTOWN SQUARE, PA 19073 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | $8K | $18K | 5.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS OF NORTHEASTERN PA EIN 23-2905083 CONTRACT ADMIN | Claims processing Service code 12 | — | $194K |
| CREATIVE BENEFITS, INC. CONTRACT ADMIN | Insurance agents and brokers Service code 22 | 3809 WEST CHESTER PIKE SUITE 190 NEWTOWN SQUARE, PA 19073 | $64K |
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 | 390 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 400 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 390 | $311K |
| Vision | VISION BENEFITS OF AMERICA | 326 | $47K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 390 | $311K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 390 | $311K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS OF NORTHEASTERN PA | 309 | $290K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 390 | $311K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 390 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.