| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WEB FIRST INSURANCE LLC3 | 271 GREENWOOD STREET WORCESTER, MA 01607 | FALLON HEALTH | $29K | — | $29K | 2.10% |
| WEBFIRST INSURANCE, LLC3 Filed as: WEBFIRST INSURANCE LLC | 271 GREENWOOD STREET WORCESTER, MA 01607 | HARTFORD LIFE AND ACCIDENT | $10K | — | $10K | 8.29% |
| WEBFIRST INSURANCE, LLC3 Filed as: WEBFIRST INSURANCE LLC | 271 GREENWOOD STREET WORCESTER, MA 01067 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 8.99% |
| MARY-JOYCE LICATA3 | 583 HATCHERY ROAD NORTH KINGSTOWN, RI 02852 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $671 | $3K | 5.30% |
| KRISTY COLGATE3 | 43 MAGILL DRIVE GRAFTON, MA 01519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $567 | $2K | 3.31% |
| ENROLLMENT SOLUTIONS LTD3 | 14 WUNSCHEL DRIVE SUTTON, MA 01590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $705 | $2K | 3.20% |
| KAREN ANGELIS3 | 17 METCALF STREET WORCESTER, MA 01609 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $980 | — | $980 | 1.80% |
| DAVID L FLEURY3 | 545 SOUTH WATER STREET PROVIDENCE, RI 02903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $343 | $200 | $543 | 1.00% |
| MICHAEL R ACKERMAN3 | 435 DEVON PARK DRIVE WAYNE, PA 19087 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $97 | — | $97 | 0.18% |
| 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 | — | $602 |
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 | 199 | 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) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FALLON HEALTH | 173 | $1.4M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 113 | $104K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 184 | $170K |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 184 | $170K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 184 | $115K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 204 | $171K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.