| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $16K | $6K | $22K | 1.48% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | HPHC INSURANCE COMPANY | $11K | $4K | $15K | 1.44% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | 1 GRIFFIN BROOK DRIVE METHUEN, MA 01844 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $4K | $14K | 11.75% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY WEST, SUITE 320 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 5.00% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | DELTA DENTAL OF NEW HAMPSHIRE, INC | $5K | $0 | $5K | 4.73% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | RED TREE INSURANCE COMPANY, INC. | $189 | $0 | $189 | 10.08% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC | PO BOX 1320 CONCORD, NJ 03302 | RED TREE INSURANCE COMPANY, INC. | $28 | $0 | $28 | 1.49% |
| CHUBB INSURANCE SOLUTIONS AGENCY3 Filed as: CHUBB INSURANCE SOLUTIONS | 202 HALLS MILLS ROAD WHITEHOUSE STATION, NJ 08889 | FEDERAL INSURANCE COMPANY | $257 | $0 | $257 | 18.04% |
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 | 118 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 78 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | 144 | $2.6M |
| Dental | DELTA DENTAL OF NEW HAMPSHIRE, INC | 224 | $109K |
| Vision | RED TREE INSURANCE COMPANY, INC. | 35 | $2K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $119K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $119K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $119K |
| Prescription drug(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | 144 | $2.6M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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."
No prospect flags tripped on this filing.