| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP INSURANCE SOLUTIONS, INC.3 | 33 BOSTON POST ROAD WEST, SUITE 120 MARLBOROUGH, MA 01752 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $45K | $7K | $52K | 2.18% |
| GROUP INSURANCE SOLUTIONS, INC.3 | 33 BOSTON POST ROAD WEST, SUITE 120 MARLBOROUGH, MA 01752 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL | $10K | — | $10K | 2.98% |
| GROUP INSURANCE SOLUTIONS, INC.3 Filed as: GROUP INSURANCE SOLUTIONS INC | 33 BOSTON POST RD W STE 120 MARLBOROUGH, MA 01752 | SUN LIFE ASSURANCE COMPANY OF CANADA | $16K | $4K | $20K | 8.33% |
| UNITED BENEFIT ADVISORS LLC3 | 20 N WAKER DR STE 500 CHICAGO, IL 60606 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $444 | $444 | 0.19% |
No Schedule C service providers reported on this filing.
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 | 253 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 585 | $2.4M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL | 631 | $326K |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 585 | $2.4M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 253 | $236K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 253 | $236K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 253 | $236K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 585 | $2.4M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 253 | $236K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 631 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.