| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 530 PRESTON AVENUE MERIDEN, CT 06450 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $58K | $15K | $73K | 2.55% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $7K | $14K | 14.06% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS STREET VIRGINIA BEACH, VA 23462 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $250 | $7K | 10.70% |
| ANTHONY J. BARBER3 | 163 CEDAR STREET BRANFORD, CT 06405 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $170 | $2K | 3.50% |
| MICHAEL C WALKER3 Filed as: MICHAEL MASSARELLI | 536 A BERLIN STREET SOUTHINGTON, CT 06489 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $370 | $2K | 3.02% |
| KAREN PICCININI3 Filed as: KAREN ANN COYLE | 163 CEDAR STREET BRANFORD, CT 06405 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $343 | $2K | 2.50% |
| ROSEANN REYNOLDS3 | 163 CEDAR STREET BRANFORD, CT 06405 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $787 | $306 | $1K | 1.60% |
| MJ INSURANCE3 Filed as: EILEEN E. BERG AND VARIOUS AGENTS | 319 THOMASTON ROAD WATERTOWN, CT 06795 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $158 | $0 | $158 | 0.23% |
| FLEURY ENTERPRISES INC3 | 162 INDIAN POINT ROAD TIVERTON, RI 02878 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $132 | $0 | $132 | 0.19% |
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 | 352 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 352 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 359 | $2.9M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 352 | $168K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 352 | $168K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 352 | $99K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 359 | $2.9M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 352 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 359 | — |
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.