| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS, LLC | DBA STRATEGIC BENEFIT ADVISORS 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | RELIASTAR LIFE INSURANCE COMPANY | $35K | — | $35K | 9.20% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS, LLC | 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $14K | $3K | $16K | 4.92% |
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS INC | 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $1K | — | $1K | 0.42% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS, LLC | 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $13K | $2K | $15K | 4.91% |
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS INC | 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $1K | — | $1K | 0.40% |
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS INC | 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $3K | — | $3K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF VERMONT EIN 03-0277307 CONTRACT ADMINISTRATOR | Claims processing; Insurance services; Contract Administrator Service code 12 | — | $764K |
| DELTA DENTAL PLAN OF VERMONT, INC. EIN 03-0219391 DENTAL CLAIMS PROCESSING | Claims processing Service code 12 | — | $80K |
| EBPA LLC EIN 20-1879465 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $25K |
| LIBERTY LIFE ASSURANCE COMPANY OF B EIN 04-6076039 STD ADMIN SERVICES ONLY | Insurance services; Contract Administrator; Claims processing Service code 12 | — | $7K |
| COMBINED SERVICES LLC EIN 02-0479434 BROKER | Insurance agents and brokers Service code 22 | — | $4K |
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 | 1,041 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,066 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 72 | $135K |
| Life insurance(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,373 | $381K |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 915 | $335K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,372 | $309K |
| Stop-loss / reinsurancereinsurance | AIG BENEFIT SOLUTIONS | 1,066 | $986K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 1,373 | $381K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,373 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.