| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC | PO BOX 28852 NEW YORK, NY 10087 | STANDARD INSURANCE COMPANY | $847 | — | $847 | 1.00% |
| WILLIS TOWERS WATSON US LLC Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $423 | — | $423 | 0.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 04-1045815 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $675K |
| MORGAN STANLEY EIN 26-4310632 NONE | Investment advisory (plan); Investment management; Investment management fees paid directly by plan Service code 27 | — | $294K |
| MANZI & ASSOCIATES LLC EIN 04-3508036 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $77K |
| DELTA DENTAL EIN 04-6143185 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $74K |
| WILLIS OF MASSACHUSETTS INC EIN 04-2392279 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $70K |
| R. JOSEPH EIN 04-2149479 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| 4A HAMPDEN TRUST EIN 04-3552834 NONE | Direct payment from the plan; Other services Service code 49 | — | $58K |
| K. ARAUJO EIN 04-2149479 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $45K |
| T. BAILOW EIN 04-2149479 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $34K |
| NNEBT DBA TEAMSTERS RX EIN 02-6015031 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $32K |
| FEINBERG, CAMPBELL & ZACK, P.C. EIN 04-2738936 NONE | Legal; Direct payment from the plan Service code 29 | — | $25K |
| D. REYES EIN 04-2149479 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $13K |
| BENEFIT CORPORATION OF AMERICA NONE | Other services; Direct payment from the plan Service code 49 | 12 WALNUT STREET STE 21 NATICK, MA 01760 | $10K |
| MERCANTILE PRESS NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 3007 BELLEVUE AVENUE WILMINGTON, DE 19802 | $7K |
| POLSINELLI PC EIN 43-1064260 NONE | Legal; Direct payment from the plan Service code 29 | — | $5K |
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 | 942 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 323 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,265 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | STANDARD INSURANCE COMPANY | 943 | $85K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. - STOP-LOSS | 1,014 | $508K |
| Other | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. - GROUP MEDEX | 255 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,014 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.