| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES | 470 ATLANTIC AVENUE BOSTON, MA 02210 | HARVARD PILGRIM HEALTH CARE | $71K | — | $71K | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES | 470 ATLANTIC AVENUE BOSTON, MA 02210 | HARVARD PILGRIM HEALTH CARE | $33K | — | $33K | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES | 470 ATLANTIC AVENUE BOSTON, MA 02210 | HARVARD PILGRIM HEALTH CARE | $18K | — | $18K | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER WGA DIVISION | 470 ATLANTIC AVENUE BOSTON, MA 02210 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $5K | $9K | 3.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER WGA DIVISION | 470 ATLANTIC AVENUE BOSTON, MA 02210 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 3.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES | 470 ATLANTIC AVENUE BOSTON, MA 02210 | HARVARD PILGRIM HEALTH CARE | $607 | — | $607 | 0.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER WGA DIVISION | 470 ATLANTIC AVENUE BOSTON, MA 02210 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 4.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES | 470 ATLANTIC AVENUE BOSTON, MA 02210 | HARVARD PILGRIM HEALTH CARE | $329 | — | $329 | 0.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES | 470 ATLANTIC AVENUE BOSTON, MA 02210 | HARVARD PILGRIM HEALTH CARE | $358 | — | $358 | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES | 470 ATLANTIC AVENUE BOSTON, MA 02210 | HARVARD PILGRIM HEALTH CARE | $303 | — | $303 | 1.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES | 470 ATLANTIC AVENUE BOSTON, MA 02210 | HARVARD PILGRIM HEALTH CARE | $271 | — | $271 | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES | 470 ATLANTIC AVENUE BOSTON, MA 02210 | HARVARD PILGRIM HEALTH CARE | $198 | — | $198 | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER WGA DIVISION | 470 ATLANTIC AVENUE BOSTON, MA 02210 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 14.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES | 470 ATLANTIC AVENUE 13TH FLOOR BOSTON, MA 02210 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | $25K | — | $25K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CONEXIS EIN 20-0198855 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $28K |
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 | 962 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 103 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,065 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts) | HARVARD PILGRIM HEALTH CARE | 1,039 | $12.4M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | 1,785 | $0 |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 962 | $323K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 866 | $162K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,000 | $304K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,785 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.