| 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 | $24K | — | $24K | 1.16% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $13K | $6K | $19K | 0.93% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, INC. | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 3.74% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $522 | — | $522 | 1.26% |
| 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 | $494 | — | $494 | 7.14% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA, LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $247 | — | $247 | 3.57% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, INC. | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $431 | $56 | $487 | 12.58% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA, LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $150 | — | $150 | 3.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MA EIN 04-1045815 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $23K |
| MARSH & MCLENNAN AGENCY, LLC BROKER | Insurance agents and brokers Service code 22 | 101 HUNTINGTON AVENUE SUITE 201 BOSTON, MA 02119 | $5K |
| BROWN & BROWN OF MA, LLC EIN 27-4732361 BROKER | Insurance agents and brokers Service code 22 | — | $5K |
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 | 230 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 139 | $2.0M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 75 | $7K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 230 | $41K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 139 | $2.0M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 230 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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.