| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN SCOTT NICOLAS3 | 6 PARK LANE MARBLEHEAD, MA 01945 | HARTFORD LIFE AND ACCIDENT | $202K | — | $202K | 5.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CONTRACT ADMIN/CLAIM | Claims processing; Direct payment from the plan; Float revenue; Named fiduciary; Other services; Contract Administrator; Participant communication; Non-monetary compensation Service code 12 | — | $4.0M |
| ANTHEM HEALTH PLANS OF NH, INC. EIN 02-0510530 CONTRACT ADMIN/CLAIM | Float revenue; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $2.3M |
| INTERCONTINENTAL US REIT EIN 11-3786306 INVESTMENT MANAGEMENT | Investment management Service code 28 | — | $559K |
| CHRISTINA KOSHA EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $353K |
| BENESYS EIN 38-2383171 SOFTWARE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $305K |
| DELTA DENTAL EIN 02-0273013 CLAIMS PROCESSING | Claims processing Service code 12 | — | $277K |
| LAW OFFICES OF FEINBERG DUMONT & BR EIN 85-4344180 LEGAL | Legal Service code 29 | — | $264K |
| ELDRIDGE INVESTMENT ADVISORS INC. EIN 02-0366808 INVESTMENT MANAGEMENT | Investment management; Named fiduciary; Investment management fees paid directly by plan Service code 28 | — | $263K |
| PHARMACEUTICAL STRATEGIES GROUP EIN 20-2422296 CONSULTING | Consulting (general) Service code 16 | — | $232K |
| METLIFE EIN 13-5581829 CONTRACT ADMIN/CLAIMS PR | Claims processing; Contract Administrator Service code 12 | — | $205K |
| PRINCIPAL ENHANCED PROPERTY FUND, L EIN 20-0928198 INVESTMENT MANAGEMENT | Investment management Service code 28 | — | $202K |
| OPTUMRX, INC EIN 33-0441200 CONTRACT ADMIN/CLAIMS PR | Claims processing; Contract Administrator Service code 12 | — | $173K |
| EICHEN, ERIC G EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $115K |
| PAUL JUSKIEWICZ EIN 36-4622924 OTHER SERVICES | Other services Service code 49 | — | $110K |
| CAROLYN MADDEN EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $106K |
| BROWN, JOHNI E EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $96K |
| WIPFLI EIN 39-0758449 ACCOUNTING | Accounting (including auditing) Service code 10 | — | $96K |
| CUTONE, JACOB B EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $96K |
| O'NEIL, PENEE-LEE L EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $94K |
| BNY EIN 13-5160382 INVESTMENT MANAGEMENT | Investment management fees paid directly by plan; Float revenue; Investment management Service code 28 | — | $90K |
| KATELYN STRAUCH EIN 02-6015031 CONSULTING | Consulting (general) Service code 16 | — | $88K |
| MARQUETTE ASSOCIATE EIN 36-3485298 INVESTMENT CONSULTANT | Investment advisory (plan) Service code 27 | — | $75K |
| SIMPSON, ANN EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $73K |
| CAMPBELL, MARSHA G EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $66K |
| ROY, DAVID EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $66K |
| PADELLARO, BENJAMIN J EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $66K |
| ALLEN, NATHAN T EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $65K |
| MACONAGHY, HEATHER EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $64K |
| LAVIGNE, CATHERINE EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $57K |
| JACQUELINE BECHT EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $56K |
| DAVID LAUGHTON (CONSULTANT) EIN 02-6015031 CONSULTING | Employee (plan); Employee (plan sponsor) Service code 30 | — | $56K |
| FITZMAURICE, JANET E EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $56K |
| MORDACH, NICHOLE A EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $53K |
| JESSICA STRATZ EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $50K |
| MARCHAND, SAMANTHA L EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $49K |
| O'LEARY, AMIE L EIN 02-0615031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $49K |
| AUBIN, JESSICA EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $49K |
| MILES, CAITLIN EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $48K |
| FRAPPIER, MARCIA EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $47K |
| BUNIE, ELAINE EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $44K |
| O'CALLAGHAN, CHLOE EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $44K |
| WOODS, MELANIE EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $42K |
| FIVEBASE, LLC EIN 27-0476813 RECORDKEEPING AND INFORM | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $35K |
| DAVIS VISION, INC. EIN 11-3051991 CONTRACT ADMIN | Claims processing; Contract Administrator Service code 12 | — | $34K |
| BLUE CROSS BLUE SHIELD OF MASS EIN 04-1045815 CONTRACT ADMIN/CLAIMS PR | Contract Administrator; Claims processing; Float revenue; Participant communication Service code 12 | — | $32K |
| CLIFTON LARSON ALLEN LLP EIN 41-0746749 CONSULTING | Consulting (general) Service code 16 | — | $31K |
| WILLIS TOWERS WATSON NORTHEAST, INC EIN 13-2695427 CONSULTING | Consulting (general) Service code 16 | — | $30K |
| VISION SERVICE PLAN EIN 06-1227840 CONTRACT ADMIN/CLAIMS PR | Claims processing; Contract Administrator Service code 12 | — | $27K |
| PLANTE, LINDA R EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $26K |
| CONNECT YOUR CARE (OPTUM FINANCIAL) EIN 26-1274092 CONTRACT ADMIN | Contract Administrator; Claims processing Service code 12 | — | $24K |
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 | 11,257 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,929 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 13,186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BCBS OF MASSACHUSETTS | 521 | $1.1M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 10,095 | $3.6M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 440 | $65K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 10,095 | $3.6M |
| Other | HARTFORD LIFE AND ACCIDENT | 10,095 | $3.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,095 | — |
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.