| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET BOSTON, MA 12110 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG INC. | $30K | $0 | $30K | 2.46% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET BOSTON, MA 12110 | TUFTS INSURANCE COMPANY | $4K | $0 | $4K | 2.35% |
| EMERSON REID LLC3 | 1787 SENTRY PKWY W STE 320 BLDG 16 BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 9.85% |
| RHONDA A DRESNER3 | 4 BENNETT ST WOBURN, MA 01801 | AFLAC | $5K | $614 | $5K | 14.67% |
| DAVID S HALLETT3 | 8 BROOKS ST WINCHESTER, MA 01890 | AFLAC | $810 | $123 | $933 | 2.59% |
| JOAN M BONNER3 | 171 LAWSON RD SCITUATE, MA 02066 | AFLAC | $576 | $0 | $576 | 1.60% |
| MARIA C CUNHA3 Filed as: MARIA C TUSINSKI | 43 WASHINGTON ST GROVELAND, MA 01834 | AFLAC | $410 | $123 | $533 | 1.48% |
| CHRISTOPHER C FEAZEL3 | 150A ANDROVER ST STE12C DANVERS, MA 01923 | AFLAC | $226 | $0 | $226 | 0.63% |
| ANDREW D WOLF3 | 4884 S MAIN ST MESILLA PARK, NM 88047 | AFLAC | $172 | $0 | $172 | 0.48% |
| MARIA C CUNHA3 Filed as: MARIA C TUSINSKI | 150A ANDROVER ST STE 12C DANVERS, MA 01834 | AFLAC | $161 | $0 | $161 | 0.45% |
| ELLEN J. GLEW3 Filed as: ELLEN J GLEW | 312 MOUNTAIN RD HARPSWELL, ME 04079 | AFLAC | $127 | $0 | $127 | 0.35% |
| ELLEN J. GLEW3 Filed as: ELLEN J GLEW | 121 CHESTNUT ST NORTH READING, MA 01864 | AFLAC | $65 | $0 | $65 | 0.18% |
| STEVEN R KARAS3 | 2000 COMMONWEALTH AVE STE 110 AUBURNDALE, MA 02466 | AFLAC | $44 | $0 | $44 | 0.12% |
| DANIEL P CLARK3 | 33 LANDAU RD PLAINVILLE, MA 02762 | AFLAC | $38 | $0 | $38 | 0.11% |
| LINDA DELONG3 Filed as: LINDA J DELONG | 150A ANDOVER ST STE 12C DANVERS, MA 01923 | AFLAC | $27 | $0 | $27 | 0.07% |
| JOHN B DRZEWIECKI JR3 Filed as: JOHN B DRZEWIECKL JR | 370 SOUTHSHIRE DR BENNINGTON, VT 05201 | AFLAC | $24 | $0 | $24 | 0.07% |
| MAUREEN E SNOW3 | 68 WINGATE RD HOLLISTON, MA 01746 | AFLAC | $15 | $0 | $15 | 0.04% |
| MATT EGAN3 | 14 GOLDEN BROOK RD WINDHAM, NH 03087 | AFLAC | $8 | $0 | $8 | 0.02% |
| JILL SCIRPO3 | 6 WILLETT POND RD WESTWOOD, MA 02090 | AFLAC | $5 | $0 | $5 | 0.01% |
| CHARLES HAYES JR.3 Filed as: CHARLES D HAYES JR | 3514 LEATHERWOOD LN MAIDENS, VA 23102 | AFLAC | $3 | $0 | $3 | 0.01% |
| THOMAS G HUNT3 | 10400 ASHLAND GATE DR APPT 112 RALEIGH, NC 27617 | AFLAC | $1 | $0 | $1 | 0.00% |
| EMERSON REID LLC3 | 350 5TH AVE STE 3700 NEW YORK, NY 10118 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 16.14% |
| GIS BENEFITS INC3 Filed as: GIS NATIONAL | 9500 KOGER AVE STE 200 ST PETERSBURG, FL 33702 | METROPOLITAN LIFE INSURANCE COMPANY | $103 | $0 | $103 | 11.02% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL ST BOSTON, MA 02110 | METROPOLITAN LIFE INSURANCE COMPANY | $94 | $0 | $94 | 10.05% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201 BLDG I SUITE 100 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $48 | $48 | 5.13% |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG INC. | 186 | $1.4M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 111 | $86K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 111 | $86K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $23K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $23K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $23K |
| Other(3 contracts, 3 carriers) | AFLAC | 144 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.