| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 12 GILL STREET - SUITE 5500 WOBURN, MA 01888 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC. | $20K | — | $20K | 1.31% |
| LAMBERT MONTALBO3 Filed as: LAMBERT&CARNEY-360 CORP BEN ADVSRS | 1375 KINGS HIGHWAY E - #215 FAIRFIELD, CT 06824 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC. | $16K | — | $16K | 1.02% |
| USI INSURANCE SERVICES LLC3 | NEW ENGLAND DIVISION PO BOX 62937 VIRGINIA BEACH, VA 23466 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC. | — | $11K | $11K | 0.68% |
| 360 CORPORATE BENEFIT ADVISORS3 | 1375 KINGS HIGHWAY E - #215 FAIRFIELD, CT 06824 | DENTAL SERVICE OF MASSACHUSETTS, INC.- DBA DELTA DENTAL OF MA | $3K | — | $3K | 4.49% |
| 360 CORPORATE BENEFIT ADVISORS3 | 1375 KINGS HIGHWAY E - #215 FAIRFIELD, CT 06824 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 12.59% |
| 360 CORPORATE BENEFIT ADVISORS3 | 1375 KINGS HIGHWAY E - #215 FAIRFIELD, CT 06824 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.91% |
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 | 165 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC. | 279 | $1.5M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC.- DBA DELTA DENTAL OF MA | 116 | $61K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $14K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $26K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 279 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.