| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS3 | 140 SYLVAN AVENUE, SUITE 303 ENGLEWOOD CLIFFS, NJ 07632 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $38K | — | $38K | 1.88% |
| ZENITH AMERICAN SOLUTIONS3 | 140 SYLVAN AVENUE, SUITE 303 ENGLEWOOD CLIFFS, NJ 07632 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $37K | — | $37K | 1.90% |
| NATIONAL GROUP PROTECTION INC3 Filed as: NATIONAL GROUP PROTECTION | 1445 GREENBRIER PLACE CHARLOTTESVILLE, VA 22901 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $118 | — | $118 | 5.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BUCHBINDER TUNICK & COMPANY LLP EIN 13-1578842 NONE | Accounting (including auditing) Service code 10 | — | $22K |
| MERRILL LYNCH EIN 13-5674085 NONE | Custodial (securities) Service code 19 | — | $20K |
| BLUE CROSS BLUE SHIELD OF MA EIN 04-1045815 NONE | Contract Administrator Service code 13 | — | $12K |
| LANGAN AND DEMPSEY EIN 04-2125930 NONE | Legal Service code 29 | — | $9K |
| CBIZ BENEFITS AND INSURANCE SVCS EIN 31-1582098 NONE | Actuarial Service code 11 | — | $7K |
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 | 243 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 243 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 302 | $4.0M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 243 | $2K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 243 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 302 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.