| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 100 FRONT STREET 20TH FLOOR WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $55K | $55K | 4.96% |
| GCG FINANCIAL LLC3 Filed as: BOSTON BENEFIT PARTNERS AN ALERA | 177 MILK STREET 3RD FLOOR BOSTON, MA 02109 | HARTFORD LIFE AND ACCIDENT | — | $6K | $6K | 0.57% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | EXPRESS SCRIPTS INC | $38K | — | $38K | 6.98% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED AMERICAN INS. CO. | $62K | — | $62K | 17.65% |
| CHRISTINE M. MCCULLUGH3 Filed as: CHRISTINE MCCULLUGH | 16310 NE 80TH STREET, SUITE 300 REDMOND, WA 98052 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | — | $20K | 15.00% |
| CHANDOR INSURANCE AGENCY LLC3 | 177 MILK STREET, 3RD FLOOR BOSTON, MA 02109 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $553 | — | $553 | 15.00% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | TRANSAMERICA INSURANCE CO. PREMIER | $229 | — | $229 | 17.68% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | ELIXIR INSURANCE COMPANY | $55 | — | $55 | 5.93% |
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 | 1,646 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,663 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED AMERICAN INS. CO. | 215 | $352K |
| Dental | DELTA DENTAL OF MASSACHUSETTS | 3,485 | $1.5M |
| Vision | VISION SERVICE PLAN | 1,180 | $219K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,646 | $1.1M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,646 | $1.1M |
| Prescription drug(3 contracts, 3 carriers) | EXPRESS SCRIPTS INC | 215 | $903K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 1,646 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,485 | — |
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.