| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | HARVARD PILGRIM HEALTH CARE | $15K | $469 | $16K | 1.87% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | HARVARD PILGRIM HEALTH CARE | $13K | $412 | $14K | 1.87% |
| HPHC INSURANCE AGENCY, INC.3 | 93 WORCESTER ST WELLESLEY HILLS, MA 02481 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 6.00% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.09% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET, STE 400 BRAINTREE, MA 02184 | RELIANCE STANDARD | $10K | — | $10K | 8.81% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD | $234 | — | $234 | 0.21% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | EYEMED VISION CARFE (ON BEHALF OF FIDELITY SECURITY LIFE INS, CO. ) | $2K | — | $2K | 10.00% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | HARVARD PILGRIM HEALTH CARE | 113 | $1.6M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $123K |
| Vision | EYEMED VISION CARFE (ON BEHALF OF FIDELITY SECURITY LIFE INS, CO. ) | 257 | $16K |
| Life insurance | RELIANCE STANDARD | 160 | $111K |
| Long-term disability | RELIANCE STANDARD | 160 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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."
No prospect flags tripped on this filing.