| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 101 HUNTINGTON AVE. SUITE 401 BOSTON, MA 02119 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $38K | $15K | $53K | 2.50% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCCLENNAN AGENCY, INC. | 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $816 | $4K | 11.51% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, INC. | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $426 | $2K | 6.64% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 101 HUNTINGTON AVENUE BOSTON, MA 02199 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $732 | — | $732 | 9.86% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, INC. | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $366 | $44 | $410 | 16.82% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MA EIN 04-1045815 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $24K |
| MARSH & MCLENNAN AGENCY, LLC BROKER | Insurance agents and brokers Service code 22 | 101 HUNTINGTON AVENUE SUITE 201 BOSTON, MA 02119 | $10K |
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 | 262 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 151 | $2.1M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 69 | $7K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 262 | $26K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 262 | $37K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 151 | $2.1M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 262 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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.