| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTH PLANS, INC.3 Filed as: HEALTH PLANS INC., MA | 1500 WEST PARK DR., SUITE 300 WESTBOROUGH, MA 01581 | UNIMERICA INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| S L MILLER INS. AGCY INC.3 | 401 EDGEWATER PL., SUITE 220 WAKEFIELD, MA 018806206 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| KENNETH W. SWAIN, JR.3 | 50 PERKINS ROW TOPSFIELD, MA 01983 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH PLANS, INC. EIN 04-2734278 THIRD PARTY ADMINISTRATOR | Claims processing; Other services Service code 12 | — | $168K |
| SEI INVESTMENTS EIN 23-3060382 NONE | Investment management; Trustee (bank, trust company, or similar financial institution); Direct payment from the plan; Investment management fees paid directly by plan; Trustee (directed); Custodial (securities) Service code 19 | — | $36K |
| CARON & BLETZER, PLLC EIN 04-3499945 ACCOUNTANT | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $21K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 304 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 304 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNIMERICA INSURANCE COMPANY | 304 | $111K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 0 | $51K |
| Prescription drug | UNIMERICA INSURANCE COMPANY | 304 | $111K |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 304 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 304 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.