| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN E OWINGS C/O OWINGS3 Filed as: JOHN E OWINGS | P.O. BOX 220 HARVARD, MA 01451 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | $0 | $19K | 7.50% |
| BOSTON COMMONWEALTH ADVANTAGE LLC3 Filed as: BOSTON COMMONWEALTH ADVANTAGE | 11 ELKINS STREET SUITE 450 BOSTON, MA 02127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | $0 | $19K | 7.50% |
| JOHN E OWINGS C/O OWINGS3 Filed as: JOHN E OWINGS | P.O. BOX 220 HARVARD, MA 01451 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $0 | $13K | 7.50% |
| BOSTON COMMONWEALTH ADVANTAGE LLC3 Filed as: BOSTON COMMONWEALTH ADVANTAGE | 11 ELKINS STREET SUITE 450 BOSTON, MA 02127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $0 | $13K | 7.50% |
| BOSTON COMMONWEALTH ADVANTAGE LLC3 Filed as: BOSTON COMMONWEALTH ADVANTAGE, LLC | 11 ELKINS STREET SUITE 450 BOSTON, MA 02127 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.01% |
| JOHN E OWINGS C/O OWINGS3 Filed as: JOHN E. OWINGS | P.O. BOX 220 HARVARD, MA 01451 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $931 | $0 | $931 | 3.95% |
| BOSTON COMMONWEALTH ADVANTAGE LLC3 Filed as: BOSTON COMMONWEALTH ADVANTAGE | 11 ELKINS STREET SUITE 450 BOSTON, MA 02127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $930 | $0 | $930 | 3.95% |
| S L MILLER INS. AGCY INC.3 Filed as: S L MILLER INSURANCE AGENCY INC. | 401 EDGEWATER PLACE SUITE 220 WAKEFIELD, MA 01880 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| KENNETH W. SWAIN, JR.3 Filed as: KENNETH W SWAIN JR. | 50 PERKINS ROW TOPSFILED, MA 01983 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $222 | $0 | $222 | 2.00% |
| 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 | $247K |
| DELTA DENTAL PLAN OF NEW HAMPSHIRE EIN 02-0273013 DENTAL CLAIMS PROCESSING | Claims processing Service code 12 | ONE DELTA DRIVE CONCORD, NH 03302 | $56K |
| BOSTON COMMONWEALTH ADVANTAGE, LLC EIN 45-3122099 BROKER | Insurance agents and brokers Service code 22 | 11 ELKINS STREET STE. 450 BOSTON, MA 02127 | $6K |
| JOHN OWINGS EIN 42-8800370 BROKER | Insurance agents and brokers Service code 22 | P.O. BOX 220 HARVARD, MA 01451 | $6K |
| COMBINED SERVICES LLC EIN 02-0479434 BROKER | Insurance agents and brokers Service code 22 | — | $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 | 494 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 494 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNIMERICA INSURANCE COMPANY | 395 | $152K |
| Vision | VISION SERVICE PLAN | 360 | $72K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 494 | $258K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 451 | $175K |
| Prescription drug | UNIMERICA INSURANCE COMPANY | 395 | $152K |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 395 | $152K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 490 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 494 | — |
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.