| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WEB FIRST INSURANCE LLC3 | 271 GREENWOOD STREET WORCESTER, MA 01607 | FALLON HEALTH | $30K | — | $30K | 2.04% |
| WEBFIRST INSURANCE, LLC3 Filed as: WEBFIRST INSURANCE LLC | 271 GREENWOOD STREET WORCESTER, MA 01607 | HARTFORD LIFE AND ACCIDENT | $11K | — | $11K | 12.63% |
| WEBFIRST INSURANCE, LLC3 Filed as: WEBFIRST INSURANCE LLC | 271 GREENWOOD STREET WORCESTER, MA 01607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 8.31% |
| MARY-JOYCE LICATA3 | 583 HATCHERY ROAD NORTH KINGSTOWN, RI 02852 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $293 | $2K | 3.44% |
| KAREN ANGELIS3 | 15 REBEKAH LANE SUTTON, MA 01590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $4 | $1K | 2.63% |
| KRISTY COLGATE3 | 43 MAGILL DRIVE GRAFTON, MA 01519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $601 | $356 | $957 | 2.12% |
| ENROLLMENT SOLUTIONS LTD3 | 14 WUNSCHEL DRIVE SUTTON, MA 01590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $519 | $398 | $917 | 2.04% |
| DAVID L FLEURY3 | 545 SOUTH MAIN STREET PROVIDENCE, RI 02903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $264 | $99 | $363 | 0.81% |
| MICHAEL R ACKERMAN3 | 150 EAST SWEDESFORD ROAD WAYNE, PA 19087 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $120 | — | $120 | 0.27% |
| WEB FIRST INSURANCE LLC3 | 271 GREENWOOD STREET WORCESTER, MA 01607 | FALLON HEALTH | $109 | — | $109 | 2.99% |
| ALLIED SOLUTIONS LLC3 | 1320 CITY CENTER DRIVE #300 CARMEL, IN 46032 | FEDERAL INSURANCE COMPANY | $180 | — | $180 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ULTRABENEFITS, INC EIN 04-3525752 SERVICE PROVIDER | Other fees Service code 99 | — | $7K |
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 | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | FALLON HEALTH | 194 | $1.5M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 121 | $110K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 183 | $135K |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 183 | $135K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 183 | $90K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 183 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.