| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $33K | $3K | $37K | 11.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $1K | $12K | 11.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $4K | — | $4K | 20.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $162 | $2K | 11.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF MASSACHUSETTS EIN 04-6143185 NONE | Claims processing Service code 12 | — | $61K |
| E4 WELLNESS, INC. EIN 46-3915492 NONE | Claims processing Service code 12 | — | $21K |
| HEALTH EQUITY, INC. EIN 52-2383166 NONE | Claims processing Service code 12 | — | $18K |
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 | 1,240 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,244 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 733 | $335K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 733 | $107K |
| Other(2 contracts, 2 carriers) | FEDERAL INSURANCE COMPANY | 1,240 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,240 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.