| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | UNKNOWN BLUE BELL, PA 19422 | INDEPENDENCE BLUE CROSS | $43K | $2K | $45K | 4.21% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL | AGENCY LLC 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS | $15K | $2K | $16K | 1.54% |
| EMERSON REID LLC3 Filed as: EMERSON REID DBA TRA BENEFIT | UNKNOWN NEW YORK, NY 10118 | UNITED CONCORDIA INSURANCE COMPANY | $7K | — | $7K | 9.11% |
| KISTLER TIFFANY BENEFITS3 | UNKNOWN BERWYN, PA 19312 | UNITED CONCORDIA INSURANCE COMPANY | $3K | — | $3K | 3.68% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC-MIDATLANTIC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 18.26% |
| KISTLER TIFFANY BENEFITS3 | GEN. AGCNY 400 BERWYN PARK STE 200899 BERWYN, PA 19312 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.98% |
| ENROLLEASE3 Filed as: ONEDIGITAL PREMIER SERVICES LLC | 400 BERWYN PARK STE 200 BERWYN, PA 19312 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $488 | $488 | 1.66% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC-MIDATLANTIC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 18.23% |
| KISTLER TIFFANY BENEFITS3 | GEN. AGCNY 400 BERWYN PARK STE 200899 BERWYN, PA 19312 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 5.02% |
| ENROLLEASE3 Filed as: ONEDIGITAL PREMIER SERVICES LLC | 400 BERWYN PARK STE 200 BERWYN, PA 19312 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $402 | $402 | 1.67% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC-MIDATLANTIC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 18.71% |
| KISTLER TIFFANY BENEFITS3 | GEN. AGNCY 400 BERWYN PARK STE 200899 BERWYN, PA 19312 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $930 | — | $930 | 4.83% |
| ENROLLEASE3 Filed as: ONEDIGITAL PREMIER SERVICES LLC | 400 BERWYN PARK STE 200 BERWYN, PA 19312 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $310 | $310 | 1.61% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC-MIDATLANTIC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $752 | $641 | $1K | 17.64% |
| KISTLER TIFFANY BENEFITS3 | GEN. AGCNY 400 BERWYN PARK STE 200899 BERWYN, PA 19312 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $433 | — | $433 | 5.48% |
| ENROLLEASE3 Filed as: ONEDIGITAL PREMIER SERVICES LLC | 400 BERWYN PARK STE 200 BERWYN, PA 19312 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $144 | $144 | 1.82% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 234661007 | VISION SERVICE PLAN | $483 | — | $483 | 6.64% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: WORLD INSURANCE ASSOCIATES | LB# 1803 PO BOX 95000 PHILADELPHIA, PA 19195 | VISION SERVICE PLAN | $244 | — | $244 | 3.36% |
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 | 114 | 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) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INDEPENDENCE BLUE CROSS | 205 | $1.1M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 234 | $76K |
| Vision | VISION SERVICE PLAN | 71 | $7K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 116 | $27K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 116 | $24K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 116 | $29K |
| Prescription drug | INDEPENDENCE BLUE CROSS | 205 | $1.1M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 116 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.