| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | UNKNOWN SPRINGFIELD, MA 01101 | HEALTH NEW ENGLAND, INC. | $35K | $0 | $35K | 3.51% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $2K | $2K | $4K | 7.07% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $4K | $10K | 20.18% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN CHICOPEE, MA 01020 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 9.31% |
| RICHARD HASKINS3 | 22 WEST STREET MILLBURY, MA 01527 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $236 | $0 | $236 | 1.40% |
| STEPHEN QUITADAMO3 | 3 KELLY STREET AUBURN, MA 01501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $136 | $0 | $136 | 0.81% |
| LISA M AMBRUSON3 Filed as: LISA M. AMBRUSON | PO BOX 1222 WARREN, MA 01083 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $67 | $0 | $67 | 0.40% |
| EDWARD H SPATER3 Filed as: EDWARD H. SPATER | PO BOX 351 EAST BROOKFIELD, MA 01515 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $48 | $0 | $48 | 0.29% |
| WENDY S FRIREE TAFT3 Filed as: WENDY S. FRIREE TAFT | PO BOX 1024 BERLIN, MA 01503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.05% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $633 | $0 | $633 | 7.13% |
| USI INSURANCE SERVICES LLC3 | 2377 BOSTON POST ROAD WILBRAHAM, MA 01095 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $81 | $0 | $81 | 0.91% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN SPRINGFIELD, MA 01101 | EMPLOYEE SERVICES, INC. | $234 | $0 | $234 | 5.00% |
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 | 138 | 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) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NEW ENGLAND, INC. | 78 | $992K |
| Dental | STANDARD INSURANCE COMPANY | 85 | $55K |
| Vision(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 125 | $64K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $49K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $49K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $49K |
| Prescription drug | HEALTH NEW ENGLAND, INC. | 78 | $992K |
| Other(4 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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.