| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET BRAINTREE, MA 02184 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $82K | $12K | $94K | 1.64% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST. SUITE 400 BRAINTREE, MA 02184 | SYMETRA | $21K | $8K | $28K | 8.16% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET BRAINTREE, MA 02184 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | $5K | — | $5K | 11.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BAYSTATE BENEFIT SERVICES BROKER | Other commissions Service code 55 | 400 WASHINGTON STREET SUITE 400 BRAINTREE, MA 02184 | $12K |
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 | 358 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 366 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 317 | $5.7M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 317 | $5.7M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | 749 | $39K |
| Life insurance | SYMETRA | 358 | $347K |
| Long-term disability | SYMETRA | 358 | $347K |
| Other | SYMETRA | 358 | $347K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 749 | — |
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.