| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 | 105 MONTGOMERY ST STE 2051 MONTGOMERY, PA 17752 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 3.62% |
| PCF INSURANCE SERVICES OF THE WEST3 | 520 HAMMIL LN RENO, NV 89511 | STANDARD INSURANCE COMPANY | $3K | $0 | $3K | 5.41% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GEN AGENCY | 899 CASSATT RD 400 BERWYN PK STE 200 BERWYN, PA 19312 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 4.55% |
| PCF INSURANCE SERVICES OF THE WEST3 | 520 HAMMIL LN RENO, NV 89511 | STANDARD INSURANCE COMPANY | $4K | $0 | $4K | 9.75% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GEN AGENCY | 899 CASSATT RD 400 BERWYN PK STE 200 BERWYN, PA 19312 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 4.55% |
| PCF INSURANCE SERVICES OF THE WEST3 | 520 HAMMIL LN RENO, NV 89511 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 7.54% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GEN AGENCY | 899 CASSATT RD 400 BERWYN PK STE 200 BERWYN, PA 19312 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 4.53% |
| PCF INSURANCE SERVICES OF THE WEST3 | PO BOX 249 MONTGOMERYVILLE, PA 18936 | EYEMED VISION CARE | $1K | $0 | $1K | 10.94% |
| PETERMAN BENEFITS3 | PO BOX 249 MONTGOMERYVILLE, PA 18936 | EYEMED | $1K | $0 | $1K | 10.94% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK OF DELAWARE EIN 51-0020405 ADMIN | Claims processing Service code 12 | — | $54K |
| PCF INSURANCE SERVICES OF THE WESTL EIN 82-1368960 BROKER | Insurance agents and brokers Service code 22 | — | $40K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $23K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $8K |
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 | 205 | 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) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 315 | $89K |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE | 205 | $22K |
| Life insurance | STANDARD INSURANCE COMPANY | 206 | $54K |
| Short-term disability | STANDARD INSURANCE COMPANY | 206 | $24K |
| Long-term disability | STANDARD INSURANCE COMPANY | 206 | $38K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 131 | $425K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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.