| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE GRP OF NE | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | HARVARD PILGRIM HEALTH CARE OF NE INC | $15K | — | $15K | 1.70% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN&BROWN INSURANCE SERVICES INC | 300 N BEACH STREET DAYTONA BEACH, FL 32114 | HARVARD PILGRIM HEALTH CARE OF NE INC | $11K | — | $11K | 1.23% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS LLC | 980 WASHINGTON STREET DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE OF NE INC | — | $6K | $6K | 0.69% |
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE GRP OF NE | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | HARVARD PILGRIM HEALTH CARE | $7K | — | $7K | 1.77% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN&BROWN INSURANCE SERVICES INC | 300 N BEACH STREET DAYTONA BEACH, FL 32114 | HARVARD PILGRIM HEALTH CARE | $5K | — | $5K | 1.28% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS, LLC | 980 WASHINGTON STREET DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE | — | $3K | $3K | 0.72% |
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE GRP OF NE | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | HARVARD PILGRIM HEALTH CARE | $1K | — | $1K | 1.90% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN&BROWN INSURANCE SERVICES INC | 300 N BEACH STREET DAYTONA BEACH, FL 32114 | HARVARD PILGRIM HEALTH CARE | $1K | — | $1K | 1.38% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS LLC | 980 WASHINGTON STREET DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE | — | $577 | $577 | 0.77% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | 144 TURNPIKE RD SUITE 330 SOUTHBOROUGH, MA 01772 | SUNLIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 13.87% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN&BROWN INSURANCE SERVICES, INC | 901 MARQUETTE AVE SUITE 1800 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $4K | — | $4K | 15.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA INC | 100 RIAL TO PLACE SUITE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | — | $713 | $713 | 2.52% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | P.O. BOX 745957 ATLANTA, GA 303745957 | FIDELITY SECURITY LIFE INSURANCE COMPANY DBA EYEMED | $773 | — | $773 | 7.51% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN&BROWN INSURANCE SERVICES INC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | FIDELITY SECURITY LIFE INSURANCE COMPANY DBA EYEMED | $255 | — | $255 | 2.48% |
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 | 142 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE OF NE INC | 110 | $1.4M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY DBA EYEMED | 146 | $10K |
| Life insurance(2 contracts, 2 carriers) | SUNLIFE ASSURANCE COMPANY OF CANADA | 142 | $61K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 142 | $28K |
| Other | SUNLIFE ASSURANCE COMPANY OF CANADA | 63 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 146 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.