| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $577 | $3K | 5.63% |
| NORTH AMERICAN BENEFITS COMPANY5 Filed as: NORTH AMERICAN BENEFITS CO | 20 VALLEY STREAM PARKWAY, SUITE 310 MALVERN, PA 19355 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 6.01% |
| WILLIAM O DAGGETT JR3 | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $603 | $402 | $1K | 5.00% |
| MICHAEL P TROY3 | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $965 | — | $965 | 4.80% |
| STEVEN D LUCAS RHU3 Filed as: STEVEN D LUCAS | 1212 BALTIMORE PIKE, SUITE 200 CHADDS FORD, PA 19317 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $844 | — | $844 | 4.20% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | — | $603 | $603 | 3.00% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 18.00% |
| NORTH AMERICAN BENEFITS COMPANY5 Filed as: NORTH AMERICAN BENEFITS CO | 20 VALLEY STREAM PARKWAY, SUITE 310 MALVERN, PA 19355 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $543 | $543 | 4.00% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| NORTH AMERICAN BENEFITS COMPANY5 Filed as: NORTH AMERICAN BENEFITS CO | 20 VALLEY STREAM PARKWAY, SUITE 310 MALVERN, PA 19312 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $316 | $316 | 4.00% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $845 | — | $845 | 14.00% |
| NORTH AMERICAN BENEFITS COMPANY5 Filed as: NORTH AMERICAN BENEFITS CO | 20 VALLEY STREAM PARKWAY SUITE 310 MALVERN, PA 19355 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $241 | — | $241 | 3.99% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS CO | 899 CASSATT ROAD, SUITE 200 BERWYN, PA 19312 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $69 | — | $69 | 19.11% |
| NORTH AMERICAN BENEFITS COMPANY5 Filed as: NORTH AMERICAN BENEFITS CO | 20 VALLEY STREAM PARKWAY, SUITE 310 MALVERN, PA 19355 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $14 | $14 | 3.88% |
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 | 217 | 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) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 198 | $58K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 113 | $14K |
| Short-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 116 | $20K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 105 | $14K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY | 108 | $344K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 113 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.