| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 | 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | $7K | $35K | 7.85% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 0.81% |
| LYONS INSURANCE AGENCY INC3 Filed as: LYONS INSURANCE AGENCY, INC. | 501 CARR ROAD, SUITE 301 WILMINGTON, DE 19809 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $1 | $1K | 0.32% |
| CHARLES D. BLOCK3 | 648 VILLAGE PARK DRIVE, UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $55 | $2 | $57 | 0.01% |
| JAMES H. VAN EPPS3 | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $55 | $1 | $56 | 0.01% |
| KISTLER TIFFANY BENEFITS3 | 400 BERWYN PARK, SUITE 200 BERWYN, PA 19312 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16K | $402 | $17K | 6.89% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $2K | $7K | 2.89% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS, INC. | 233 SOUTH WACKER DRIVE, SUITE 2000 CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 1.18% |
| LYONS INSURANCE AGENCY INC3 Filed as: LYONS INSURANCE AGENCY, INC. | 501 CARR ROAD, SUITE 301 WILMINGTON, DE 19809 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 0.79% |
| LYONS INSURANCE AGENCY INC3 Filed as: LYONS INSURANCE AGENCY, INC. | 501 CARR ROAD, SUITE 301 WILMINGTON, DE 19809 | NGL | $4K | $0 | $4K | 10.00% |
| LYONS INSURANCE AGENCY INC3 Filed as: LYONS INSURANCE AGENCY, INC. | 501 CARR ROAD, SUITE 301 WILMINGTON, DE 19809 | HEALTHIEST YOU | $560 | $0 | $560 | 15.01% |
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 | 582 | 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) | 582 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHIEST YOU | 20 | $4K |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 881 | $257K |
| Vision | NGL | 716 | $44K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 881 | $443K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 867 | $240K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 881 | $443K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 881 | $687K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 881 | — |
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.