| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTIONS INC. | 24 E SECOND ST 1ST FL MEDIA, PA 19063 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $107K | $0 | $107K | 8.59% |
| TRIBEN INSURANCE SOLUTIONS INC3 | 15 E FRONT ST MEDIA, PA 19063 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $47K | $0 | $47K | 3.82% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL AG | 400 BERWYN PARK 899 CASSATT RD STE 200 BERWYN, PA 19312 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $47K | $0 | $47K | 3.82% |
| IMG5 | 2960 NORTH MERIDIAN ST INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $211 | $211 | 0.02% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL AG | 899 CASSATT RD STE 200 BERWYN, PA 19312 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | $95K | $0 | $95K | 9.92% |
| TRIBEN INSURANCE SOLUTIONS INC3 | 24 E 2ND ST MEDIA, PA 19063 | TRANSAMERICA LIFE INSURANCE COMPANY | $13K | $0 | $13K | 11.23% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL | 400 BERWYN PARK STE 200 BERWYN, PA 19312 | TRANSAMERICA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 5.32% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 4651 WEST CHESTER PIKE NEWTON SQUARE, PA 19073 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.14% |
| BENESERV, INC.3 Filed as: BENESERV INC | 15 E FRONT ST MEDIA, PA 19063 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $990 | $0 | $990 | 10.01% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PWKY W, VEVA 16 BLUE BELL, PA 19422 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $495 | $495 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE PRUDENTIAL INSURANCE COMPANY OF EIN 22-1211670 ADMIN | Claims processing Service code 12 | — | $50K |
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 | 1,298 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 56 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,354 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 1,263 | $960K |
| Vision | INDEPENDENCE ADMINISTRATORS | 1,298 | $0 |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 589 | $10K |
| Short-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 946 | $1.2M |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 946 | $1.2M |
| Other(2 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 946 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,298 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.