| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER-TIFFANY BENEFITS CO | 400 BERWYN PARK BERWYN, PA 19312 | HIGHMARK DELAWARE | $49K | — | $49K | 2.64% |
| WILLIAMS INSURANCE AGENCY3 | PO BOX 1174 REHOBOTH BEACH, DE 19971 | HARTFORD LIFE AND ACCIDENT | $7K | $3K | $10K | 13.69% |
| O'NEILL VOLUNTARY BENEFIT SERVICES3 | 5626 KIRKWOOD HIGHWAY WILMINGTON, DE 19808 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $382 | $3K | 8.58% |
| NICHOLAS CUSMANO3 | 79 PORT HERMAN RD CHESAPEAKE CY, MD 21915 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $693 | — | $693 | 2.25% |
| CHESAPEAKE INSURANCE ADVISORS3 | PMN 552 KENNETT SQ, PA 19348 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $595 | — | $595 | 1.93% |
| ROTH VOLUNTARY BENEFIT SERVICES INC3 | 9 DEARBORN LANE BEAR, DE 19701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | — | $40 | 0.13% |
| LISA A PERRI3 | 775 ROUTE 70 EAST MARLTON, NJ 08053 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.08% |
| PLATINUM ENROLLMENT SPECIALISTS3 Filed as: PLATINUM ENROLOMENT SPECIALISTS | 100 CHALLENGER ROAD STE 105 RIDGEFIELD PARK, NJ 07660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.06% |
| JAMES BARTLETT LLC3 Filed as: JAMES BARLETT LLC | 3138 GREENRIDGE DRIVE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| GIANNA DAMBROSIO3 | 23 LONGVIEW DRIVE MAHOPAC, NY 10541 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| MICHAEL J PERRI3 | 775 ROUTE 70 EAST MARLTON, NJ 08053 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| THE WILLIAMS AGENCY INC INSURANCE3 | P O BOX 1240 HOCKESSIN, DE 197075240 | VISION SERVICE PLAN | $1K | — | $1K | 5.43% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INSURANCE | 1 KELLY WAY SPARKS, MD 21152 | VISION SERVICE PLAN | $520 | — | $520 | 2.50% |
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 | 180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK DELAWARE | 321 | $1.9M |
| Dental | HIGHMARK DELAWARE | 321 | $1.9M |
| Vision | VISION SERVICE PLAN | 136 | $21K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 316 | $74K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 316 | $74K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 316 | $105K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 321 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.