| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PLAN MARKETING INSURANCE AGENCY INC3 Filed as: PLAN MARKETING INS AGENCY INC | PO BOX 5199 WESTBOROUGH, MA 01581 | SYMETRA LIFE INSURANCE COMPANY | — | $13K | $13K | 1.37% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $1K | $6K | 4.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF MASS LLC | 333 ELM STREET SUITE 300 DEDHAM, MA 02026 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $495 | $990 | $1K | 0.93% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF MASS LLC | 333 ELM STREET SUITE 300 DEDHAM, MA 02026 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $776 | $4K | 3.85% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $423 | $1K | 1.51% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $232 | $5K | 9.15% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF MASS LLC | 333 ELM STREET SUITE 300 DEDHAM, MA 02026 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $447 | $4K | 7.12% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $597 | $5K | 9.96% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF MASS LLC | 333 ELM STREET SUITE 300 DEDHAM, MA 02026 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $1K | $4K | 8.68% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | EYEMED VISION CARE | $1K | — | $1K | 4.74% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF MASS LLC | 333 ELM STREET SUITE 300 DEDHAM, MA 02026 | EYEMED VISION CARE | $1K | — | $1K | 4.46% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 27.75% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF MASS LLC | 333 ELM STREET SUITE 300 DEDHAM, MA 02026 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $749 | — | $749 | 11.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH PLANS, INC. EIN 04-2734278 THIRD PARTY ADMINISTRATOR | Other services; Claims processing Service code 12 | 1500 WEST PARK DRIVE WESTBOROUGH, MA 01581 | $386K |
| DELTA DENTAL PLAN OF NEW HAMPSHIRE EIN 02-0273013 DENTAL CLAIMS PROCESSING | Claims processing Service code 12 | ONE DELTA DRIVE CONCORD, NH 03302 | $58K |
| HRC TOTAL SOLUTIONS EIN 30-0041952 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | 111 CHARLES STREET MANCHESTER, NH 03101 | $6K |
| FRED C. CHURCH INC. EIN 04-2445292 BROKER | Insurance agents and brokers Service code 22 | 41 WELLMAN STREET LOWELL, MA 01851 | $5K |
| BROWN & BROWN OF MASSACHUSETTS LLC EIN 27-4732361 BROKER | Insurance agents and brokers Service code 22 | 333 ELM STREET SUITE 300 DEDHAM, MA 02026 | $5K |
| COMBINED SERVICES LLC DBA CSONE BEN EIN 02-0479434 BROKER | Insurance agents and brokers Service code 22 | TWO DELTA DRIVE CONCORD, NH 03302 | $3K |
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 | 844 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 844 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 538 | $29K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 698 | $95K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 844 | $160K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 556 | $979K |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 698 | $211K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 844 | — |
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.