| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL ST. FL 2 BOSTON, MA 021101700 | HARVARD PILGRIM HEALTH CARE | $9K | — | $9K | 2.53% |
| MICHAEL P TSOTSIS3 Filed as: MICHAEL TSOTSIS | 446 MAIN ST., STE 19 WORCESTER, MA 016082368 | HARVARD PILGRIM HEALTH CARE | $12 | — | $12 | 0.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL ST. FL 2 BOSTON, MA 021101700 | HARVARD PILGRIM HEALTH CARE | $6K | — | $6K | 2.53% |
| MICHAEL P TSOTSIS3 Filed as: MICHAEL TSOTSIS | 446 MAIN ST. STE 19 WORCESTER, MA 016082368 | HARVARD PILGRIM HEALTH CARE | $8 | — | $8 | 0.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL ST. FL 2 BOSTON, MA 021101700 | HARVARD PILGRIM HEALTH CARE | $5K | — | $5K | 2.51% |
| MICHAEL P TSOTSIS3 Filed as: MICHAEL TSOTSIS | 446 MAIN ST. STE 19 WORCESTER, MA 016082368 | HARVARD PILGRIM HEALTH CARE | $7 | — | $7 | 0.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL ST. FL 2 BOSTON, MA 021101700 | ALTUS DENTAL INSURANCE COMPANY, INC. | $2K | — | $2K | 5.14% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL ST. FL 2 BOSTON, MA 021101700 | HARVARD PILGRIM HEALTH CARE | $746 | — | $746 | 2.53% |
| MICHAEL P TSOTSIS3 Filed as: MICHAEL TSOTSIS | 446 MAIN ST. STE 19 WORCESTER, MA 016082368 | HARVARD PILGRIM HEALTH CARE | $1 | — | $1 | 0.00% |
| AISLING PARTNERS INSURANCE BROKERAG3 Filed as: AISLING PARTNERS INS BRKRGE LLC | 25 HARVARD STREET WORCESTER, MA 01609 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 14.09% |
| AISLING PARTNERS INSURANCE BROKERAG3 Filed as: AISLING PARTNERS INS BRKRGE LLC | 25 HARVARD STREET WORCESTER, MA 01609 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.09% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL ST. FL 2 BOSTON, MA 021101700 | ALTUS DENTAL INSURANCE COMPANY, INC. | $600 | — | $600 | 5.14% |
| AISLING PARTNERS INSURANCE BROKERAG3 Filed as: AISLING PARTNERS INS BRKRGE LLC | 25 HARVARD STREET WORCESTER, MA 01609 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $917 | — | $917 | 10.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL ST. FL 2 BOSTON, MA 021101700 | VSP | $576 | — | $576 | 8.83% |
| FRED C. CHURCH INC.3 Filed as: FRED C. CHURCH | 41 WELLMAN STREET LOWELL, MA 01851 | ZURICH AMERICAN INSURANCE COMPANY | $405 | — | $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 | 144 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | ALTUS DENTAL INSURANCE COMPANY, INC. | 52 | $42K |
| Vision | VSP | 32 | $7K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 129 | $18K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 113 | $18K |
| Other(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 129 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 129 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.