| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEVIN M HARRINGTON3 | 770 DEDHAM ST STE 1 CANTON, MA 02021 | HARTFORD LIFE & ACCIDENT INS. CO. | $16K | — | $16K | 5.00% |
| THE SEGAL COMPANY3 Filed as: SEGAL COMPANY (EASTERN STATES) | 333 WEST 34TH ST NEW YORK, NY 10001 | HCC LIFE INSURANCE COMPANY | $17K | — | $17K | 7.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PDC ADMINISTRATIVE ACCOUNT EIN 04-2824420 AFFILIATED FUND | Direct payment from the plan; Contract Administrator Service code 13 | — | $961K |
| TUFTS HEALTH PLAN EIN 04-2985923 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $958K |
| THE SEGAL COMPANY EIN 13-1928058 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $249K |
| DELTA DENTAL EIN 04-6143185 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $173K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $139K |
| EMPLOYEE C EIN 04-2150983 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $135K |
| EMPLOYEE G EIN 04-2150983 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $93K |
| AMERICAN REALTY ADVISORS EIN 33-0123114 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $93K |
| MODERN ASSISTANCE EIN 04-3014253 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $81K |
| EMPLOYEE I EIN 04-2150983 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $79K |
| EMPLOYEE F EIN 04-2150983 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $75K |
| SUN LIFE CAPITAL MANAGEMENT LLC EIN 68-0635051 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $74K |
| EMPLOYEE B EIN 04-2150983 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $70K |
| EMPLOYEE H EIN 04-2150983 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $69K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $62K |
| EMPLOYEE M EIN 04-2150983 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $60K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $54K |
| FEINBERG, DUMONT & BRENNAN EIN 04-2738936 NONE | Legal; Direct payment from the plan Service code 29 | — | $51K |
| ZELIS CLAIMS INTEGRITY INC EIN 47-4319823 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $49K |
| COMMONWEALTH OF MASSACHUSETTS EIN 04-6002284 NONE | Direct payment from the plan; Other services Service code 49 | — | $38K |
| BOSTON PARTNERS GLOBAL INVESTORS EIN 98-0202744 NONE | Investment management fees paid directly by plan; Soft dollars commissions; Investment management Service code 28 | — | $35K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Investment management; Investment management fees paid directly by plan; Other investment fees and expenses Service code 28 | — | $33K |
| UNION LABOR LIFE INSURANCE COMPANY EIN 13-1423090 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $32K |
| LOOMIS SAYLES LP EIN 20-8080381 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $30K |
| O'REILLY, GROSSO GROSS & JONES PC EIN 04-3318596 NONE | Legal; Direct payment from the plan Service code 29 | — | $30K |
| MIDWEST INSTITUTIONAL TRUST COMPANY | Custodial (securities); Direct payment from the plan Service code 19 | 5901 COLLEGE BLVD., STE 100 OVERLAND PARK, KS 66211 | $23K |
| ALLIANCE BERNSTEIN EIN 13-4064930 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $18K |
| DAVIS VISION EIN 11-3051991 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $12K |
| VALENZ PROTEKHT, LLC NONE | Direct payment from the plan; Consulting (general) Service code 16 | DEPT. 392, P.O. BOX 1000 MEMPHIS, TN 38148 | $10K |
| STATE STREET GLOBAL ADVISORS EIN 81-4017137 NONE | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Custodial (securities); Investment management Service code 19 | — | $9K |
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 | 2,114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 822 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,936 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE & ACCIDENT INS. CO. | 2,442 | $326K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 2,011 | $250K |
| Other | HARTFORD LIFE & ACCIDENT INS. CO. | 2,442 | $326K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,442 | — |
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.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.