| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 446 MAIN ST 5TH FL WORCESTER, MA 01608 | SYMETRA LIFE INSURANCE COMPANY | $13K | — | $13K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 04-1045815 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $858K |
| DELTA DENTAL EIN 04-6143185 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $116K |
| HANNON, L. EIN 04-2145367 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $91K |
| MODERN ASSISTANCE PROGRAMS INC EIN 04-3014253 NONE | Direct payment from the plan; Other services Service code 49 | — | $90K |
| RUBINSTEIN ACTUARIAL SERVICES, LLC EIN 04-2792279 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $71K |
| BARKER, S. EIN 04-2145367 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $69K |
| RASO, C. EIN 04-2145367 EXECUTIVE DIRECTOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $63K |
| ERNA, P. EIN 04-2145367 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| INNOVATIVE SOFTWARE SOLUTIONS EIN 23-2182079 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $52K |
| GAITA, R. EIN 04-2145367 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $45K |
| FEINBERG, DUMONT & BRENNAN EIN 04-2738936 NONE | Legal; Direct payment from the plan Service code 29 | — | $39K |
| VALLETTA, A. EIN 04-2145367 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $37K |
| MANZI & ASSOCIATES, LLC EIN 04-3508036 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $36K |
| SARNO, G. EIN 04-2145367 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $35K |
| HARVEY, K. EIN 04-2145367 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $33K |
| SMITH, J. EIN 04-2145367 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $27K |
| SEGAL MARCO ADVISORS INC. EIN 13-1835864 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $25K |
| IR&M INTERMEDIATE FUND NONE | Investment management; Investment management fees paid indirectly by plan Service code 28 | — | $22K |
| PRU CORE BOND FUND NONE | Investment management; Investment management fees paid indirectly by plan Service code 28 | — | $22K |
| DAMIGELLA, C. EIN 04-2145367 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $21K |
| BEAUDRY, W. EIN 04-2145367 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $16K |
| PETRILLO, P. EIN 04-2145367 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $13K |
| DAVIS VISION EIN 11-3051991 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $10K |
| STATE STREET GLOBAL ADVISORS EIN 04-1867445 NONE | Soft dollars commissions; Custodial (securities); Custodial (other than securities); Investment management fees paid indirectly by plan Service code 18 | — | $10K |
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 | 1,754 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 240 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,996 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 2,060 | $256K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MA | 1,883 | $746K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 2,060 | $256K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,060 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.