| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CITISTREET ASSOCIATES, LLC3 | ENTERPRISE GENERAL INSURANCE AGENCY 300 DAVIDSON AVENUE, 1ST FLOOR SOMERSET, NJ 08875 | TRANSAMERICA LIFE INSURANCE COMPANY | $18 | — | $18 | 4.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| METROPOLITAN LIFE INSURANCE COMPANY RECORDKEEPER | Recordkeeping fees Service code 64 | 300 DAVIDSON AVENUE SOMERSET, NJ 08873 | $207K |
| METLIFE SECURITIES INC. BROKER/ADVISER | Other commissions Service code 55 | 1095 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | $31K |
| NEW ENGLAND PRIVATE WEALTH ADVISORS INVESTMENT ADVISING | Investment advisory (plan) Service code 27 | 36 WASHINGTON STREET SUITE 395 WELLESLEY, MA 02481 | $15K |
| FEELEY & DRISCOLL, PC AUDITOR | Accounting (including auditing) Service code 10 | 200 PORTLAND ST BOSTON, MA 02114 | $12K |
| NATIONWIDE LIFE INSURANCE COMPANY EIN 31-4156830 RECORDKEEPER | Recordkeeping fees Service code 64 | — | $372 |
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 | 1,582 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 32 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 214 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,828 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 49 | $364 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 49 | — |
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.