| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 100 FRONT STREET WORCESTER, MA 01608 | SYMETRA LIFE INSURANCE COMPANY | $15K | — | $15K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 04-1045815 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $1.1M |
| DELTA DENTAL EIN 04-6143185 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $112K |
| HANNON, L. EIN 04-2145367 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $102K |
| RASO, C. EIN 04-2145367 EXECUTIVE DIRECTOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $85K |
| PILLAR RX CONSULTING NONE | Direct payment from the plan; Consulting (general) Service code 16 | 10700 W RESEARCH DRIVE SUITE 3 WAUWATOSA, WI 53226 | $78K |
| WILLIS TOWERS WATSON NONE | Direct payment from the plan; Actuarial Service code 11 | 75 ARLINGTON ST. FLOOR 2 BOSTON, MA 02116 | $76K |
| HARVEY, T. EIN 04-2145367 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $63K |
| AMALGAMATED BANK EIN 13-4920330 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $60K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796478 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $53K |
| ROSE, M EIN 04-2145367 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $49K |
| HARVEY, K. EIN 04-2145367 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $47K |
| HORIZON ACTUARIAL SERVICES EIN 26-1370698 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $46K |
| FEINBERG, DUMONT & BRENNAN EIN 04-2738936 NONE | Legal; Direct payment from the plan Service code 29 | — | $39K |
| MANZI & ASSOCIATES, LLC EIN 04-3508036 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $37K |
| DAMIGELLA, C. EIN 04-2145367 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $36K |
| MODERN ASSISTANCE PROGRAMS INC EIN 04-3014253 NONE | Direct payment from the plan; Other services Service code 49 | — | $30K |
| SEGAL MARCO ADVISORS INC. EIN 13-1835864 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $26K |
| BEAUDRY, W. EIN 04-2145367 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $21K |
| PETRILLO, P. EIN 04-2145367 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $20K |
| DAVIS VISION EIN 11-3051991 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $9K |
| SMITH, J. EIN 04-2145367 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $8K |
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 | 1,621 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 298 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,919 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 2,004 | $293K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MA | 1,772 | $885K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 2,004 | $293K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,004 | — |
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."
No prospect flags tripped on this filing.