| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KD BENEFITS4 | 6 PARK LANE MARBLEHEAD, MA 01945 | AETNA | $7K | — | $7K | 6.32% |
| KD BENEFITS4 | 6 PARK LANE MARBLEHEAD, MA 01945 | DELTA DENTAL | $5K | — | $5K | — |
| KD BENEFITS4 | 6 PARK LANE MARBLEHEAD, MA 01945 | BLUE CROSS BLUE SHIELD | $25K | — | $25K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 04-1045815 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $956K |
| ROBERT KEOGH EIN 04-2088633 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $213K |
| DELTA DENTAL EIN 04-6143185 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $96K |
| GWENETTE DRUMGOLD EIN 04-2088633 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| JUDITH FINCH EIN 04-2088633 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $67K |
| ENVISION PHARMACEUTICAL EIN 05-0570786 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $64K |
| LORRAINE FORREST EIN 04-2088633 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $54K |
| MCDONNELL INVESTMENT MGMT, LLC EIN 36-4445613 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $50K |
| ISSI EIN 23-2182079 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $46K |
| CALIBRE CPA GROUP EIN 36-2131790 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $31K |
| MARCO CONSULTING EIN 36-3555078 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $28K |
| BANK OF AMERICA EIN 94-1687665 NONE | Custodial (securities); Investment management fees paid directly by plan Service code 19 | — | $27K |
| SEGAL COMPANY EIN 13-1928058 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $25K |
| SEGAL, ROITMAN EIN 13-2646110 NONE | Legal; Direct payment from the plan Service code 29 | — | $22K |
| MANZI & ASSOCIATES EIN 04-3508036 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $21K |
| MODERN ASSISTANCE EIN 04-3014253 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $15K |
| EATON VANCE EIN 04-3101341 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $12K |
| DAVIS VISION EIN 11-3051991 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $10K |
| SAVITZ ORGANIZATION EIN 26-1371674 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $7K |
| STATE STREET GLOBAL ADVISORS EIN 04-1867445 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $4K |
| MESIROW ADVANCED STRATEGIES EIN 36-3741067 NONE | Investment management; Investment management fees paid indirectly by plan Service code 28 | — | $0 |
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 | 1,508 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 519 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,027 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD | 4,620 | $0 |
| Dental | DELTA DENTAL | 3,928 | $0 |
| Life insurance | AETNA | 1,375 | $115K |
| Other | AETNA | 1,375 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,620 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.