| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | HARVARD PILGRIM HEALTH CARE | $35K | — | $35K | 1.47% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $1K | $12K | 7.98% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $150 | $3K | 15.80% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | EYEMED VISION CARE | $1K | — | $1K | 10.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DENTAL SERVICE OF MASSACHUSETTS EIN 04-6143185 THIRD PARTY ADMINSTRATOR | Claims processing Service code 12 | 465 MEDFORD STREET BOSTON, MA 02129 | $23K |
| HRC TOTAL SOLUTIONS EIN 30-0041952 THIRD PARTY ADMINSTRATOR | Claims processing Service code 12 | 111 CHARLES STREET MANCHESTER, NH 03101 | $9K |
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 | 276 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 378 | $2.4M |
| Vision | EYEMED VISION CARE | 171 | $12K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 276 | $144K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 276 | $144K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 276 | $144K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 276 | $164K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 378 | — |
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.