| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: BORISLOW INSURANCE | ONE GRIFFON BROOK DRIVE METHUEN, MA 01844 | BERKLEY LIFE AND HEALTH | — | $94K | $94K | 14.97% |
| BLUE BENEFIT ADMINISTRATORS OF MASS5 | P.O. BOX 55917 BOSTON, MA 022055917 | BERKLEY LIFE AND HEALTH | — | $65K | $65K | 10.33% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE 2ND FLOOR METHUEN, MA 01844 | DELTA DENTAL OF MA | $1K | — | $1K | 1.63% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A BORISLOW INS AGENCY INC. | 1 GRIFFIN BROOK DR METHUEN, MA 01844 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $6K | 8.25% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A BORISLOW INS AGENCY INC. | 1 GRIFFIN BROOK DR METHUEN, MA 01844 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $736 | $5K | 12.39% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A BORISLOW INS AGENCY INC. | 1 GRIFFIN BROOK DR METHUEN, MA 01844 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $382 | $2K | 11.99% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $55 | — | $55 | 0.77% |
| UNITED OF OMAHA LIFE INSURANCE CO5 Filed as: UNITED OF OMAHA LIFE INSURANCE COMP | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | — |
| ASSUREDPARTNERS3 Filed as: JENNIFER A BORISLOW INS AGENCY INC. | 1 GRIFFIN BROOK DR METHUEN, MA 01844 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $99 | $99 | — |
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 | 134 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BERKLEY LIFE AND HEALTH | 97 | $629K |
| Dental | DELTA DENTAL OF MA | 160 | $91K |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 103 | $7K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $19K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $0 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $37K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 188 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.