| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN SCOTT NICOLAS3 | 6 PARK LANE MARBLEHEAD, MA 01945 | HARTFORD LIFE AND ACCIDENT | $206K | — | $206K | 5.72% |
| 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; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $2.4M |
| LAW OFFICES OF DUMONT, MORRIS EIN 04-3098453 LEGAL | Legal Service code 29 | — | $469K |
| CHRISTINA KOSHA EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $393K |
| DELTA DENTAL EIN 02-0273013 CLAIMS PROCESSING | Claims processing Service code 12 | — | $284K |
| ELDRIDGE INVESTMENT ADVISORS INC. EIN 02-0366808 INVESTMENT MANAGEMENT | Investment management fees paid directly by plan; Investment management; Named fiduciary Service code 28 | — | $250K |
| PHARMACEUTICAL STRATEGIES GROUP EIN 20-2422296 CONSULTING | Consulting (general) Service code 16 | — | $245K |
| BENESYS EIN 38-2383171 SOFTWARE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $245K |
| PRINCIPAL ENHANCED PROPERTY FUND LP EIN 20-0928198 INVESTMENT MGMT | Investment management Service code 28 | — | $230K |
| OPTUMRX EIN 33-0441200 PHARMACY BENEFIT MGMT | Claims processing; Float revenue; Other fees; Direct payment from the plan Service code 12 | — | $208K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CONTRACT ADMIN/CLAIM | Claims processing; Contract Administrator Service code 12 | — | $207K |
| KATELYN STRAUCH EIN 02-6015031 ADMINISTRATION/CONSULTIN | Employee (plan); Employee (plan sponsor) Service code 30 | — | $177K |
| INTERCONTINENTAL US REIT EIN 11-3786306 INVESTMENT MANAGEMENT | Investment management Service code 28 | — | $129K |
| ERIC EICHEN EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $121K |
| JACOB CUTONE EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $119K |
| CAROLYN MADDEN EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $118K |
| PAUL JUSKIEWICZ EIN 36-4622924 OTHER SERVICES | Other services Service code 49 | — | $112K |
| PENEE-LEE O'NEIL EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $103K |
| JOHNI BROWN EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $102K |
| WIPFLI LLP EIN 39-0758449 ACCOUNTING | Accounting (including auditing) Service code 10 | — | $96K |
| LINEA SOLUTIONS, INC EIN 95-4723968 RECORDKEEPING/INFO MGMT | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $86K |
| ALLIANCEBERNSTEIN HOLDING L.P. EIN 13-3434400 INVESTMENT MGMT | Investment management Service code 28 | — | $85K |
| HEATHER MACONAGHY EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $77K |
| MARSHA CAMPBELL EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $75K |
| MARQUETTE ASSOCIATE EIN 36-3485298 INVESTMENT CONSULTANT | Investment advisory (plan) Service code 27 | — | $75K |
| BNY EIN 13-5160382 INVESTMENT MANAGEMENT | Investment management fees paid directly by plan; Float revenue; Investment management Service code 28 | — | $74K |
| NATHAN ALLEN EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $74K |
| DAVID ROY EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $74K |
| BENJAMIN PADELLARO EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $72K |
| ANN SIMPSON EIN 02-6015031 EMPLOYEE/ADMIN | Employee (plan sponsor); Employee (plan) Service code 30 | — | $69K |
| FIVEBASE, LLC EIN 27-0476813 RECORDKEEPING/INFO MGMT | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $65K |
| JACQUELINE BECHT EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $65K |
| SAMANTHA MARCHAND EIN 02-0615031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $58K |
| JANET FITZMAURICE EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $58K |
| ELIZABETH MACEDO EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $57K |
| JAMES TANG EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $56K |
| MELISSA JACKSON EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $56K |
| CATHERINE LAVIGNE EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $56K |
| CAITLIN MILES EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $55K |
| NICHOLE MORDACH EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $55K |
| CHLOE O'CALLAGHAN EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $54K |
| AMIE O'LEARY EIN 02-6015031 EMPLOYEE/ADMIN | Employee (plan sponsor); Employee (plan) Service code 30 | — | $54K |
| JESSICA AUBIN EIN 02-6015031 ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $54K |
| MARCIA FRAPPIER EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $53K |
| MELANIE WOODS EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $51K |
| AMANDA SULLIVAN EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $44K |
| MICHELE DERBY EIN 02-6015031 ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $37K |
| BLUE CROSS BLUE SHIELD OF MASS EIN 04-1045815 CONTRACT ADMIN/CLAIM | Participant communication; Float revenue; Contract Administrator; Claims processing Service code 12 | — | $35K |
| FIRST AMERICAN ADMINISTRATORS, INC. EIN 86-0773195 CONTRACT ADMIN/CLAIMS | Contract Administrator; Claims processing Service code 12 | — | $29K |
| WORLDPAY EIN 26-4372027 OTHER FEES | Other fees Service code 99 | — | $28K |
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 | 12,287 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,089 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 13,376 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BCBS OF MASSACHUSETTS | 558 | $1.1M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 9,980 | $3.6M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 9,980 | $3.6M |
| Other | HARTFORD LIFE AND ACCIDENT | 9,980 | $3.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,980 | — |
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.