| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN SCOTT NICOLAS3 | 6 PARK LANE MARBLEHEAD, MA 01945 | HARTFORD LIFE AND ACCIDENT | $209K | — | $209K | 5.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CONTRACT ADMIN/CLAIM | Claims processing; Float revenue; Other services; Participant communication; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Named fiduciary Service code 12 | — | $4.1M |
| ANTHEM HEALTH PLANS OF NH, INC. EIN 02-0510530 CONTRACT ADMIN/CLAIM | Float revenue; Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $2.4M |
| CHRISTINA KOSHA EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $320K |
| BENESYS EIN 38-2383171 SOFTWARE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $309K |
| DELTA DENTAL EIN 02-0273013 CLAIMS PROCESSING | Claims processing Service code 12 | — | $258K |
| ELDRIDGE INVESTMENT ADVISORS INC. EIN 02-0366808 INVESTMENT MANAGEMENT | Investment management; Investment management fees paid directly by plan; Named fiduciary Service code 28 | — | $251K |
| LAW OFFICES OF FEINBERG DUMONT & BR EIN 85-4344180 LEGAL | Legal Service code 29 | — | $248K |
| PHARMACEUTICAL STRATEGIES GROUP EIN 20-2422296 CONSULTING | Consulting (general) Service code 16 | — | $208K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CONTRACT ADMIN/CLAIM | Contract Administrator; Claims processing Service code 12 | — | $196K |
| OPTUMRX EIN 33-0441200 CONTRACT ADMIN/CLAIM | Contract Administrator; Claims processing Service code 12 | — | $148K |
| LAW OFFICES OF DUMONT, MORRIS EIN 04-3098453 LEGAL | Legal Service code 29 | — | $128K |
| BNY EIN 13-5160382 INVESTMENT MANAGEMENT | Float revenue; Investment management; Investment management fees paid directly by plan Service code 28 | — | $125K |
| PAUL JUSKIEWICZ EIN 36-4622924 OTHER SERVICES | Other services Service code 49 | — | $112K |
| ERIC EICHEN EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $104K |
| INTERCONTINENTAL US REIT EIN 11-3786306 INVESTMENT MANAGEMENT | Investment management Service code 28 | — | $99K |
| DAVID LAUGHTON EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $96K |
| CAROLYN MADDEN EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $94K |
| JACOB CUTONE EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $90K |
| JOHNI BROWN EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $83K |
| CATHERINE LAVIGNE EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $81K |
| PENEE-LEE O'NEIL EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $75K |
| MARQUETTE ASSOCIATE EIN 36-3485298 INVESTMENT CONSULTANT | Investment advisory (plan) Service code 27 | — | $75K |
| WIPFLI LLP EIN 39-0758449 ACCOUNTING | Accounting (including auditing) Service code 10 | — | $73K |
| ANN SIMPSON EIN 02-6015031 EMPLOYEE/ADMIN | Employee (plan sponsor); Employee (plan) Service code 30 | — | $72K |
| DANIEL SULLIVAN EIN 02-6015031 CONSULTING | Consulting (general) Service code 16 | — | $63K |
| MARSHA CAMPBELL EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $58K |
| DAVID ROY EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $57K |
| HEATHER MACONAGHY EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $56K |
| JANET FITZMAURICE EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $54K |
| JACQUELINE BECHT EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $52K |
| NICHOLE MORDACH EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $50K |
| AMIE O'LEARY EIN 02-6015031 EMPLOYEE/ADMIN | Employee (plan); Employee (plan sponsor) Service code 30 | — | $48K |
| JESSICA STRATZ EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $45K |
| JESSICA AUBIN EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $44K |
| SAMANTHA MARCHAND EIN 02-0615031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $44K |
| MARCIA FRAPPIER EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $43K |
| ANNA KELLY EIN 02-6015031 EMPLOYEE/ADMIN | Employee (plan); Employee (plan sponsor) Service code 30 | — | $42K |
| BENJAMIN PADELLARO EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $40K |
| ELAINE BUNIE EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan sponsor); Employee (plan) Service code 30 | — | $40K |
| DAVIS VISION, INC. EIN 11-3051991 CONTRACT ADMIN | Contract Administrator; Claims processing Service code 12 | — | $36K |
| MELANIE WOODS EIN 02-6015031 EMPLOYEE/ADMINISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $36K |
| HOLB GROUP OF NEW ENGLAND EIN 20-1906078 ACTUARIAL | Actuarial Service code 11 | — | $35K |
| BLUE CROSS BLUE SHIELD OF MASS EIN 04-1045815 CONTRACT ADMIN/CLAIM | Participant communication; Float revenue; Contract Administrator; Claims processing Service code 12 | — | $34K |
| VISION SERVICE PLAN EIN 06-1227840 CONTRACT ADMIN/CLAIM | Claims processing; Contract Administrator Service code 12 | — | $32K |
| CONNECT YOUR CARE EIN 26-1274092 CONTRACT ADMIN | Contract Administrator; Claims processing Service code 12 | — | $24K |
| DOUGLAS JAY KATZ, DMD EIN 02-0511476 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $24K |
| BRIAN RAINVILLE EIN 02-6015031 CONSULTING | Consulting (general) Service code 16 | — | $24K |
| PURE AIR HEATING AND COOLING LLC EIN 85-2659382 CONSULTING | Consulting (general) Service code 16 | — | $20K |
| THOMAS J. SYNAN, MD EIN 02-6015031 CONTRACT ADMIN | Consulting (general); Contract Administrator Service code 13 | — | $18K |
| CAITLIN MILES EIN 02-6015031 EMPLOYEE/ADMIMNISTRATION | Employee (plan); Employee (plan sponsor) Service code 30 | — | $17K |
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 | 16,036 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,763 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 17,799 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BCBS OF MASSACHUSETTS | 597 | $1.2M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 10,174 | $3.7M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 10,174 | $3.7M |
| Other | HARTFORD LIFE AND ACCIDENT | 10,174 | $3.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,174 | — |
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.