| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET ST STE 400 BETHLEHEM, PA 180185749 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 12.65% |
| NORTH AMERICAN BENEFITS COMPANY3 | 20 VALLEY STREAM PARKWAY SUITE 310 MALVERN, PA 19355 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $743 | $743 | 3.00% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS COMPANY | 400 BERWYN PARK BERWYN, PA 19312 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $504 | $0 | $504 | 2.03% |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET ST STE 400 BETHLEHEM, PA 180185749 | MADISON NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 12.00% |
| NORTH AMERICAN BENEFITS COMPANY5 | 20 VALLEY STREAM PARKWAY MALVERN, PA 19355 | MADISON NATIONAL LIFE INSURANCE COMPANY | $0 | $836 | $836 | 8.50% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS COMP | 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | MADISON NATIONAL LIFE INSURANCE COMPANY | $0 | $295 | $295 | 3.00% |
| WILLIAM O DAGGETT JR3 Filed as: WILLIAM O. DAGGETT JR. | 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | MADISON NATIONAL LIFE INSURANCE COMPANY | $0 | $197 | $197 | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 ADMIN | Claims processing Service code 12 | — | $6K |
| NATIONAL VISION ADMINISTRATORS, LLC EIN 74-3033381 ADMIN | Claims processing Service code 12 | — | $934 |
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 | 112 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | MADISON NATIONAL LIFE INSURANCE COMPANY | 96 | $10K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 112 | $25K |
| Other | MADISON NATIONAL LIFE INSURANCE COMPANY | 96 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 112 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.