| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | HARVARD PILGRIM HEALTH CARE | $28K | $0 | $28K | 1.85% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | HARVARD PILGRIM HEALTH CARE | $18K | $0 | $18K | 1.20% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | $8K | $314 | $8K | 3.37% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | HPHC INSURANCE COMPANY | $3K | $0 | $3K | 1.74% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | HPHC INSURANCE COMPANY | $2K | $0 | $2K | 1.23% |
| ASSUREDPARTNERS3 Filed as: BORISLOW INSURANCE AGENCY, INC. | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $7K | $20K | 16.41% |
| ASSUREDPARTNERS3 Filed as: BORISLOW INSURANCE AGENCY, INC. | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $2K | $0 | $2K | 10.92% |
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 | 322 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 328 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 508 | $3.3M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | 468 | $250K |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 229 | $16K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 332 | $119K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 332 | $119K |
| Prescription drug(4 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 508 | $3.3M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 332 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 508 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.