| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBS INSURANCE BROKERS3 | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 1.46% |
| EBS INSURANCE BROKERS3 | 1 GATEWAY CENTER STE 650 NEWTON, MA 02458 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 2.76% |
| EBS INSURANCE BROKERS3 | 1 GATEWAY CENTER STE 650 NEWTON, MA 02458 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 9.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTH SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $542K |
| DELTA DENTAL PLAN OF NEW HAMPSHIRE EIN 02-0273013 CLAIMS PROCESSING | Claims processing Service code 12 | — | $61K |
| TRUVERIS INC EIN 27-4345686 CONSULTING | Consulting (general); Consulting fees Service code 16 | — | $0 |
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 | 861 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 873 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,042 | $381K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 861 | $238K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,042 | — |
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.