| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS INC | $46K | $15K | $61K | 3.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOC | 470 ATLANTIC AVENUE BOSTON, MA 02210 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS INC | $14K | — | $14K | 0.69% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | DELTA DENTAL OF MASSACHUSETTS | $4K | — | $4K | 2.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOC INS BROKERS | 470 ATLANTIC AVENUE BOSTON, MA 02210 | DELTA DENTAL OF MASSACHUSETTS | $543 | — | $543 | 0.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOC INS BROKERS | 470 ATLANTIC AVENUE BOSTON, MA 02210 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $451 | $3K | 8.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOC INS BROKERS | 470 ATLANTIC AVENUE BOSTON, MA 02210 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $375 | $3K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOC INS BROKERS | 470 ATLANTIC AVENUE BOSTON, MA 02210 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $340 | $3K | 14.53% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | VISION SERVICE PLAN | $535 | — | $535 | 4.85% |
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 | 172 | 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) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS INC | 290 | $2.0M |
| Dental | DELTA DENTAL OF MASSACHUSETTS | 324 | $147K |
| Vision | VISION SERVICE PLAN | 106 | $11K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 172 | $36K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 160 | $28K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 160 | $24K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 172 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 324 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.