| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS | 400 BERWYN PARK, SUITE 899 CASSATT ROAD BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS - KEYSTONE HEALTH | $104K | — | $104K | 6.36% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS | 400 BERWYN PARK, SUITE 200 899 CASSATT ROAD BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS - PERSONAL CHOICE | $37K | — | $37K | 6.50% |
| HR&S FINANCIAL SERVICES LLC3 | 1515 MARKET STREET SUITE 1700 PHILADELPHIA, PA 19102 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 4.79% |
| AXA ASSISTANCE, USA3 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $109 | $109 | 0.08% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS | 400 BERWYN PARK, SUITE 200 899 CASSATT ROAD BERWYN, PA 19312 | AETNA LIFE INSURANCE CO. | $5K | — | $5K | 4.59% |
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 | 322 | 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) | 322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | INDEPENDENCE BLUE CROSS - KEYSTONE HEALTH | 250 | $2.2M |
| Dental | AETNA LIFE INSURANCE CO. | 338 | $111K |
| Vision | INDEPENDENCE BLUE CROSS - PERSONAL CHOICE | 77 | $568K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 322 | $133K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 322 | $133K |
| Prescription drug(3 contracts, 3 carriers) | INDEPENDENCE BLUE CROSS - KEYSTONE HEALTH | 250 | $2.2M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 322 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 338 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.