| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG, INC. | $36K | $8K | $44K | 3.69% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | DELTA DENTAL OF MASSACHUSETTS | $4K | — | $4K | 3.98% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $906 | $3K | 14.75% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $856 | $3K | 19.64% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | VISION SERVICE PLAN | $529 | — | $529 | 7.37% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $696 | — | $696 | 10.01% |
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 | 142 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG, INC. | 131 | $1.2M |
| Dental | DELTA DENTAL OF MASSACHUSETTS | 137 | $94K |
| Vision | VISION SERVICE PLAN | 53 | $7K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 142 | $7K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 45 | $19K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 142 | $17K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 142 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.