| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN SCOTT NICOLAS3 Filed as: JOHN S NICOLAS | 6 PARK LANE MARBLEHEAD, MA 01945 | SYMETRA LIFE INSURANCE COMPANY | $112K | — | $112K | 7.00% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 446 MAIN ST, 5TH FL WORCESTER, MA 01608 | SYMETRA LIFE INSURANCE COMPANY | $64K | — | $64K | 4.00% |
| JOHN SCOTT NICOLAS3 | 6 PARK LANE MARBLEHEAD, MA 01945 | AETNA | $50K | — | $50K | 3.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NONE | Claims processing; Direct payment from the plan; Contract Administrator; Float revenue; Other services; Participant communication; Non-monetary compensation Service code 12 | — | $3.8M |
| ANTHEM HEALTH PLANS OF NH, INC. EIN 02-0510530 NONE | Float revenue; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | 1351 WM. HOWARD TAFT RD. CINCINNATI, OH 452061721 | $2.2M |
| LAW OFFICES OF DUMONT, MORRIS EIN 04-3098453 NONE | Legal Service code 29 | — | $309K |
| BENESYS EIN 38-2383171 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $303K |
| DAVID LAUGHTON EIN 02-6015031 TRUSTEE & EMPLOYEE | Trustee (individual); Named fiduciary; Employee (plan); Employee (plan sponsor) Service code 20 | — | $281K |
| DELTA DENTAL PLAN OF NEW HAMPSHIRE EIN 02-0273013 NONE | Claims processing Service code 12 | — | $232K |
| PHARMACEUTICAL STRATEGIES GROUP EIN 20-2422296 NONE | Consulting (general) Service code 16 | — | $196K |
| ELDRIDGE INVESTMENT ADVISORS, INC EIN 02-0366808 NONE | Named fiduciary; Investment management fees paid directly by plan; Investment management Service code 28 | — | $175K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5881829 NONE | Claims processing; Contract Administrator Service code 12 | — | $140K |
| CHRISTINA KOSHA EIN 02-6015031 EMPLOYEE | Employee (plan); Employee (plan sponsor) Service code 30 | — | $136K |
| INTERCONTINENTAL US REIT EIN 11-3786306 NONE | Investment management Service code 28 | — | $121K |
| CATHERINE LAVIGNE EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $116K |
| HOME VISION C/O PAUL JUSKIEWICZ EIN 36-4622924 NONE | Other services Service code 49 | — | $95K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 NONE | Investment management fees paid directly by plan; Investment management; Float revenue Service code 28 | — | $94K |
| DANIEL SULLIVAN, RPH EIN 02-6015031 NONE | Consulting (general) Service code 16 | — | $83K |
| MARQUETTE ASSOCIATES, INC. EIN 36-3485298 NONE | Investment advisory (plan) Service code 27 | — | $75K |
| HOWE, RILEY & HOWE, PLLC EIN 20-3985821 NONE | Accounting (including auditing) Service code 10 | — | $75K |
| ANN SIMPSON EIN 02-6015031 EMPLOYEE | Employee (plan); Employee (plan sponsor) Service code 30 | — | $71K |
| MARCIA LAUGHTON EIN 02-6015031 EMPLOYEE | Employee (plan); Employee (plan sponsor) Service code 30 | — | $66K |
| PENEE-LEE O'NEIL EIN 02-6015031 EMPLOYEE | Employee (plan); Employee (plan sponsor) Service code 30 | — | $51K |
| JACOB CUTONE EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $50K |
| MARSHA CAMPBELL EIN 02-6015031 EMPLOYEE | Employee (plan); Employee (plan sponsor) Service code 30 | — | $50K |
| JOHNI BROWN EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $49K |
| HEATHER MACONAGHY EIN 02-6015031 EMPLOYEE | Employee (plan); Employee (plan sponsor) Service code 30 | — | $47K |
| JANET FITZMAURICE EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $47K |
| AMIE O'LEARY EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $47K |
| LINDA PLANTE EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $46K |
| JACQUELINE BECHT EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $46K |
| RABEYA KHATUN EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $44K |
| NICHOLE MORDACH EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $44K |
| DAVIS VISION, INC EIN 11-3051991 NONE | Contract Administrator; Claims processing Service code 12 | — | $40K |
| JESSICA ENO EIN 02-6015031 EMPLOYEE | Employee (plan); Employee (plan sponsor) Service code 30 | — | $39K |
| JESSICA STRATZ EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $39K |
| MARCIA FRAPPIER EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $39K |
| ELAINE BUNIE EIN 20-6015031 EMPLOYEE | Employee (plan); Employee (plan sponsor) Service code 30 | — | $38K |
| MPL LLC EIN 06-1537302 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | 23 MAIDEN LANE NORTH HAVEN, CT 06473 | $36K |
| BLUE CROSS BLUE SHIELD OF MASS EIN 04-1045815 NONE | Float revenue; Claims processing; Participant communication; Contract Administrator Service code 12 | — | $34K |
| MELANIE WOODS EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $32K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Contract Administrator; Claims processing Service code 12 | — | $32K |
| LAURA SARGENT EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $28K |
| DANA CONRAD EIN 02-6015031 EMPLOYEE | Employee (plan sponsor); Employee (plan) Service code 30 | — | $28K |
| GEORGE BIRON, DMD EIN 02-0343317 NONE | Contract Administrator Service code 13 | — | $24K |
| DBR GROUP EIN 20-1906078 NONE | Actuarial Service code 11 | — | $20K |
| THOMAS J. SYNAN, MD EIN 02-6015031 NONE | Consulting (general); Contract Administrator Service code 13 | — | $19K |
| ENVISION ANALYST EIN 33-0996975 NONE | Consulting (general) Service code 16 | — | $17K |
| CORPORATE RISK ADVISORS-MANAGERS IN EIN 04-2532724 NONE | Consulting (general) Service code 16 | PO BOX 290788, SIX CITY SQUARE BOSTON, MA 02111 | $13K |
| INTERCONTINENTAL RE INVESTMENT FUND EIN 04-3549299 NONE | Investment management Service code 28 | — | $11K |
| ROBERT PICCONE EIN 02-6015031 TRUSTEE | Trustee (individual); Named fiduciary Service code 20 | — | $10K |
| ROBERT ROBICHAUD EIN 02-6015031 TRUSTEE | Trustee (individual); Named fiduciary Service code 20 | — | $10K |
| COMBINED SERVICES, LLC DBA CSONE BE EIN 02-0479434 NONE | Insurance agents and brokers Service code 22 | — | $10K |
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 | 10,389 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 941 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 11,330 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BCBS OF MASSACHUSETTS | 328 | $560K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 8,965 | $1.6M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,413 | $2.5M |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,564 | $4.1M |
| Other | SYMETRA LIFE INSURANCE COMPANY | 8,965 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,965 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.