| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | TUFTS ASSOCIATED HEALTH MAINTANANCE ORG. INC. | $27K | — | $27K | 2.72% |
| YOURPEOPLE, INC.3 Filed as: YOURPEOPLE, INC. DBA ZENEFITS | DEPT LA 24402 PASADENA, CA 911854402 | TUFTS ASSOCIATED HEALTH MAINTANANCE ORG. INC. | $2K | — | $2K | 0.22% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | DENTAL SERVICE OF MA DBA DELTA DENTAL | $5K | — | $5K | 5.03% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 12.64% |
| ZENEFITS3 | DEPT LA 24402 PASADENA, CA 91185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $549 | — | $549 | 2.37% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.00% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $725 | — | $725 | 11.42% |
| ZENEFITS3 | DEPT LA 24402 PASADENA, CA 91185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $68 | — | $68 | 1.07% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | VISION SERVICE PLAN | $468 | — | $468 | 9.99% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $180 | — | $180 | 11.41% |
| ZENEFITS3 | DEPT LA 24402 PASADENA, CA 91185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17 | — | $17 | 1.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP DYNAMIC INC. EIN 01-0453342 THIRD PARTY ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 411 US ROUTE ONE FALMOUTH, ME 04105 | $7K |
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 | 201 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TUFTS ASSOCIATED HEALTH MAINTANANCE ORG. INC. | 147 | $1.0M |
| Dental | DENTAL SERVICE OF MA DBA DELTA DENTAL | 164 | $93K |
| Vision | VISION SERVICE PLAN | 53 | $5K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 201 | $6K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 23 | $9K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 190 | $23K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 201 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 201 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.