| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS, LLC | 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $169K | $89K | $258K | 2.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS, LLC | 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | — | $138 | $138 | 0.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS, LLC | DBA STRATEGIC BENEFIT ADVISORS 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $32K | — | $32K | 10.00% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $100 | $100 | 0.03% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA | DBA STRATEGIC BENEFIT ADVISORS 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | COMBINED INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 10.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRUDENTIAL INSURANCE CO OF AMERICA EIN 22-1211670 FMLA THIRD-PARTY ADMIN | Contract Administrator Service code 13 | — | $69K |
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 | 727 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 738 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 737 | $12.7M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 737 | $12.7M |
| Vision | COMBINED INSURANCE COMPANY OF AMERICA | 305 | $18K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 896 | $316K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 896 | $316K |
| Other(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 896 | $13.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 896 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.