| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK KRUPKOWSKI3 | 1538 TURNPIKE STREET NORTH ANDOVER, MA 01845 | SYMETRA LIFE INSURANCE COMPANY | $76K | — | $76K | 8.00% |
| PLAN MARKETING INSURANCE AGENCY INC0 | PO BOX 5199 WESTBOROUGH, MA 015815199 | SYMETRA LIFE INSURANCE COMPANY | $38K | — | $38K | 4.00% |
| MARK KRUPKOWSKI3 Filed as: MARK KRUPOKOWSKI | 1538 TURNPIKE STREET STE 404 NORTH ANDOVER, MA 01845 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | — | $20K | 8.13% |
| DELTA DENTAL PLAN OF NEW HAMPSHIRE0 | ONE DELTA DRIVE CONCORD, NH 03302 | NORTHEAST DELTA DENTAL | $43K | — | $43K | — |
| MARK KRUPKOWSKI0 | 1538 TURNPIKE STREET SUITE 404 NORTH ANDOVER, MA 01845 | NORTHEAST DELTA DENTAL | $9K | — | $9K | — |
| COMBINED SERVICES LLC0 | TWO DELTA DRIVE SUITE 301 CONCORD, NH 03302 | NORTHEAST DELTA DENTAL | $2K | — | $2K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH PLANS INC EIN 04-2734278 THIRD PARTY ADMINISTRATOR | Claims processing; Other services Service code 12 | 1500 WEST PARK DRIVE WESTBOROUGH, MA 01581 | $272K |
| DELTA DENTAL PLAN OF NEW HAMPSHIRE EIN 02-0273013 DENTAL CLAIMS PROCESSING | Claims processing Service code 12 | ONE DELTA DRIVE CONCORD, NH 033022002 | $43K |
| MARK KRUPKOWSKI EIN 01-1549606 BROKER | Insurance agents and brokers Service code 22 | 1538 TURNPIKE STE 404 NORTH ANDOVER, MA 01845 | $9K |
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 | 439 | 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) | 439 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SYMETRA LIFE INSURANCE COMPANY | 439 | $948K |
| Dental | NORTHEAST DELTA DENTAL | 466 | $0 |
| Vision | SYMETRA LIFE INSURANCE COMPANY | 439 | $948K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,555 | $242K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,555 | $242K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 439 | $948K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,555 | $242K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,555 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.