| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SVCS. LLC | 200 SEAPORT BOULEVARD SUITE V2B BOSTON, MA 02210 | AETNA LIFE INSURANCE COMPANY | $36K | $0 | $36K | 1.36% |
| USI INSURANCE SERVICES LLC3 | 12 GILL STREET WOBURN, MA 01801 | AETNA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 0.25% |
| INDIGO INSURANCE SERVICES3 | 101 HUNTINGTON AVENUE BOSTON, MA 02199 | USABLE LIFE | $22K | $0 | $22K | 20.48% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SVCS. LLC | UNKNOWN FRAMINGHAM, MA 01702 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $1K | $0 | $1K | 10.94% |
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 | 231 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 344 | $2.7M |
| Dental | AETNA LIFE INSURANCE COMPANY | 344 | $2.7M |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 206 | $12K |
| Life insurance | USABLE LIFE | 230 | $106K |
| Long-term disability | USABLE LIFE | 230 | $106K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 344 | $2.7M |
| Other | USABLE LIFE | 230 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 344 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.