| 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. | $19K | — | $19K | 5.00% |
| THE SEGAL COMPANY3 Filed as: SEGAL COMPANY (EASTERN STATES) | 333 WEST 34TH ST NEW YORK, NY 10001 | HCC LIFE INSURANCE COMPANY | $21K | — | $21K | 7.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PDC ADMINISTRATIVE ACCOUNT EIN 04-2824420 AFFILIATED FUND | Contract Administrator; Direct payment from the plan Service code 13 | — | $1.6M |
| HARVARD PILGRIM HEALTH EIN 04-2452600 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $334K |
| TUFTS HEALTH PLAN EIN 04-2985923 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $275K |
| THE SEGAL COMPANY EIN 13-1928058 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $197K |
| DELTA DENTAL EIN 04-6143185 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $178K |
| EMPLOYEE C EIN 04-2150983 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $137K |
| EMPLOYEE G EIN 04-2150983 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $103K |
| FEINBERG, DUMONT & BRENNAN EIN 04-2738936 NONE | Legal; Direct payment from the plan Service code 29 | — | $90K |
| MODERN ASSISTANCE EIN 04-3014253 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $85K |
| AMERICAN REALTY ADVISORS EIN 33-0123114 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $82K |
| EMPLOYEE F EIN 04-2150983 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $80K |
| EMPLOYEE I EIN 04-2150983 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $79K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $72K |
| EMPLOYEE B EIN 04-2150983 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $72K |
| EMPLOYEE H EIN 04-2150983 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $68K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $64K |
| EMPLOYEE M EIN 04-2150983 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $61K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $60K |
| EMPLOYEE O EIN 04-2150983 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| EMPLOYEE N EIN 04-2150983 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| MIDIOR CONSULTING, INC. EIN 04-2240176 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $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 | — | $48K |
| SUN LIFE CAPITAL MANAGEMENT LLC EIN 68-0635051 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $41K |
| BLUE HARBOR TECHNOLOGY NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 992 BEDFORD STREET BRIDGEWATER, MA 02324 | $36K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Investment management; Other investment fees and expenses; Investment management fees paid directly by plan Service code 28 | — | $35K |
| UNION LABOR LIFE INSURANCE COMPANY EIN 13-1423090 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $34K |
| LOOMIS SAYLES LP EIN 20-8080381 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $33K |
| O'REILLY, GROSSO GROSS & JONES PC EIN 04-3318596 NONE | Legal; Direct payment from the plan Service code 29 | — | $32K |
| BOSTON PARTNERS GLOBAL INVESTORS EIN 98-0202744 NONE | Investment management fees paid directly by plan; Investment management; Soft dollars commissions Service code 28 | — | $26K |
| SUMMIT STRATEGIES, LLC EIN 81-0969890 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $22K |
| ALLIANCE BERNSTEIN EIN 13-4064930 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $21K |
| COMMONWEALTH OF MASSACHUSETTS EIN 04-6002284 NONE | Direct payment from the plan; Other services Service code 49 | — | $19K |
| MIDWEST INSTITUTIONAL TRUST COMPANY EIN 48-1138946 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $11K |
| DAVIS VISION EIN 11-3051991 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $10K |
| STATE STREET GLOBAL ADVISORS EIN 81-4017137 NONE | Investment management; Investment management fees paid directly by plan; Custodial (securities); Investment management fees paid indirectly by plan 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 | 2,097 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 857 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,954 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE & ACCIDENT INS. CO. | 2,512 | $382K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 2,127 | $305K |
| Other | HARTFORD LIFE & ACCIDENT INS. CO. | 2,512 | $382K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,512 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.