| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 711 EAST MAIN STREET, SUITE 201 CHICOPEE, MA 01020 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $29K | $5K | $34K | 3.29% |
| USI INSURANCE SERVICES LLC3 | 711 EAST MAIN STREET, SUITE 201 CHICOPEE, MA 01020 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | $0 | $4K | 7.49% |
| USI INSURANCE SERVICES LLC3 | 711 EAST MAIN STREET, SUITE 201 CHICOPEE, MA 01020 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 6.58% |
| RICHARD HASKINS3 | 22 WEST STREET MILLBURY, MA 01527 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $295 | $0 | $295 | 1.04% |
| STEPHEN QUITADAMO3 | 3 KELLY STREET AUBURN, MA 01501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $174 | $0 | $174 | 0.61% |
| LISA M AMBRUSON3 Filed as: LISA M. AMBRUSON | PO BOX 1222 WARREN, MA 01083 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $84 | $0 | $84 | 0.30% |
| EDWARD H SPATER3 Filed as: EDWARD H. SPATER | PO BOX 351 EAST BROOKFIELD, MA 01515 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $70 | $0 | $70 | 0.25% |
| WENDY S FRIREE TAFT3 Filed as: WENDY S. FRIREE TAFT | PO BOX 1024 BERLIN, MA 01503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.04% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $704 | $0 | $704 | 8.01% |
| USI INSURANCE SERVICES LLC3 | 2377 BOSTON POST ROAD WILBRAHAM, MA 01095 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $559 | $0 | $559 | 6.36% |
| THE GAUDREAU GROUP INC.3 Filed as: THE GAUDREAU GROUP, INC. | 2377 BOSTON ROAD WILBRAHAM, MA 01095 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $133 | $0 | $133 | 1.51% |
| USI INSURANCE SERVICES LLC3 | 711 EAST MAIN STREET, SUITE 201 CHICOPEE, MA 01020 | EMPLOYEE SERVICES, INC. | $258 | $0 | $258 | 5.00% |
| USI INSURANCE SERVICES LLC3 | 711 EAST MAIN STREET, SUITE 201 CHICOPEE, MA 01020 | NATIONAL UNION FIRE INSURANCE CO. OF PITTSBURGH, PA | $405 | $0 | $405 | 15.00% |
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 | 109 | 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) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 213 | $1.0M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 213 | $1.0M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 122 | $9K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 109 | $49K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 109 | $49K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 109 | $49K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 213 | $1.0M |
| Other(4 contracts, 4 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 131 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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.