| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL AG | 400 BERWYN PARK BERWYN, PA 19312 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $120 | $4K | 24.14% |
| TERESA BURNS3 | 2025 WHITE DEER TRAIL MALVERN, PA 19355 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 10.28% |
| BENECHOICE ENROLLMENT SOLUTIONS3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $318 | $144 | $462 | 2.86% |
| ARDENA L MCVICKER3 | 73 KATYDID LANE MORGANTOWN, PA 19543 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $301 | $96 | $397 | 2.46% |
| PETRINA SKILES3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $216 | $15 | $231 | 1.43% |
| JS BENEFITS GROUP INC3 Filed as: JS BENEFITS GROUP, INC. | 54 FRIENDS LN NEWTOWN, PA 18940 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $91 | $0 | $91 | 0.56% |
| HARRY LORE3 | 4 GLANFORD CROSSING MEDFORD, NJ 08055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $72 | $0 | $72 | 0.45% |
| MERRIDITH STANTON3 | 456 LAKE COMO DR POMONA PARK, FL 32181 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $64 | $0 | $64 | 0.40% |
| WILLIAM A GRAHAM COMPANY3 | ONE PENN SQUARE WEST PHILADELPHIA, PA 19102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | $0 | $53 | 0.33% |
| INTEGRITY ASSOCIATES INS. SERVICES3 Filed as: INTEGRITY INSURANCE INC | 123 PINE VALLEY DR MIDDLETOWN, DE 19709 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | $0 | $45 | 0.28% |
| JULIA GEORGE3 | 123 WINCHESTER ROAD MERION STATION, PA 19066 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.17% |
| HARMONY BENEFITS LLC3 | 17 MIDBRIDGE DR MEDFORD, NJ 08055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $0 | $19 | 0.12% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.11% |
| DONALD C SAVOY INC3 Filed as: DONALD C SAVOY INC. TA SAVOY ASSOC. | 25B HANOVER RD FLORHAM PARK, NJ 07932 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.07% |
| SOTERIA PARTNERS LLC3 | 77 HAGGERTY DRIVE WEST ORANGE, NJ 07502 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIGITAL INSURANCE BROKER | Insurance agents and brokers Service code 22 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | $31K |
| INDEPENDENCE ADMINISTRATORS EIN 23-2184623 ADMIN | Claims processing Service code 12 | — | $24K |
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 | 162 | 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) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 0 | $0 |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 0 | $0 |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 0 | $0 |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SWISS RE CORPORATE SOLUTIONS AMERICA INS. CORP. | 162 | $297K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 20 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 162 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.