| 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. | $54K | $10K | $64K | 2.60% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $4K | $10K | 11.70% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS STREET VIRGINIA BEACH, VA 23462 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $51 | $7K | 10.23% |
| ANTHONY J. BARBER3 | 163 CEDAR STREET BRANDFORD, CT 06405 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $272 | $3K | 4.09% |
| MICHAEL C WALKER3 Filed as: MICHAEL MASSARELLI | 536 A BERLIN STREET SOUTHINGTON, CT 06489 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $205 | $2K | 3.59% |
| ROSEANN REYNOLDS3 | 163 CEDAR STREET BRANFORD, CT 06405 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $956 | $297 | $1K | 1.92% |
| KAREN PICCININI3 Filed as: KAREN ANN COYLE | 163 CEDAR STREET BRANFORD, CT 06405 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $997 | $226 | $1K | 1.87% |
| MICHAEL R ACKERMAN3 Filed as: MICHAEL R. ACKERMAN | 435 DEVON PARK DRIVE WAYNE, PA 19087 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $547 | $33 | $580 | 0.89% |
| FLEURY ENTERPRISES INC3 Filed as: FLEURY ENTERPRISES AND OTHER AGENTS | 162 INDAIN POINT ROAD TIVERTON, RI 02878 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $306 | $22 | $328 | 0.50% |
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 | 230 | 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) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 295 | $2.5M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 250 | $150K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 250 | $150K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 250 | $85K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 295 | $2.5M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 250 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 295 | — |
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.