| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $364 | $5K | 9.91% |
| FRED C. CHURCH INC.3 Filed as: FRED C CHURCH INC. | 41 WELLMAN STREET LOWELL, MA 01851 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 8.89% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $610 | $320 | $930 | 2.18% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $113 | $2K | 10.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE BENEFIT ADMINISTRATORS OF MASS EIN 27-1502067 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | PO BOX 55917 BOSTON, MA 02205 | $136K |
| FRED C CHURCH INC. EIN 04-2445292 BROKER | Insurance agents and brokers Service code 22 | 41 WELLMAN STREET LOWELL, MA 01851 | $72K |
| THE GUARDIAN LIFE INSURANCE COMPANY EIN 13-5123390 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | 7 HANOVER SQUARE NEW YORK, NY 10004 | $25K |
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 | 373 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 373 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 588 | $44K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 373 | $15K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 106 | $49K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MA | 349 | $376K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 373 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 588 | — |
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.