| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SAPERS & WALLACK3 Filed as: SAPERS WALLACK INS AGY | ONE NEWTON PLACE, 275 WASHINGTON ST NEWTON, MA 02458 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 4.68% |
| SAPERS & WALLACK3 Filed as: SAPERS WALLACK INS AGY | ONE NEWTON PLACE, 275 WASHINGTON ST NEWTON, MA 02458 | STANDARD INSURANCE COMPANY | $982 | — | $982 | 0.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TUFTS HEALTH PLAN/CARELINK EIN 04-2674079 NONE | Other commissions; Claims processing; Direct payment from the plan Service code 12 | — | $736K |
| BOSTON TRUST & INVESTMENT COMPANY EIN 04-2273811 NONE | Investment management; Trustee (discretionary); Trustee (bank, trust company, or similar financial institution); Custodial (securities); Direct payment from the plan; Trustee (directed); Investment management fees paid directly by plan Service code 19 | — | $170K |
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $156K |
| SEGAL COMPANY EIN 13-1928058 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $123K |
| ANNE FINI EIN 04-2163872 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $106K |
| MODERN ASSISTANCE EIN 04-3014253 NONE | Direct payment from the plan; Other insurance fees and expenses Service code 50 | — | $78K |
| CHARLIE WRIGHT EIN 04-2163872 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $72K |
| KAREN FINI EIN 04-2163872 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $66K |
| PATRICIA DOYLE EIN 04-2163872 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| BARBARA CONNERS EIN 04-2163872 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $60K |
| MANZI & ASSOCIATES LLC EIN 04-3508036 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $54K |
| VERONICA DYER EIN 04-2163872 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $52K |
| MICKEY LONG, ESQ. EIN 04-3534086 NONE | Legal; Direct payment from the plan Service code 29 | — | $49K |
| LYN TABAJONDA EIN 04-2163872 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $46K |
| ANNE BLUNDELL EIN 04-2163872 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $43K |
| EDNA DOYLE EIN 04-2163872 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $43K |
| INNOVATIVE SOFTWARE SOLUTIONS EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $28K |
| HEATHER ROMERI EIN 04-2163872 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $27K |
| JOANNE PENWARDEN EIN 04-2163872 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $22K |
| SEGAL ROITMAN, LLP EIN 13-2646110 NONE | Legal; Direct payment from the plan Service code 29 | — | $22K |
| PATTY POWERS EIN 04-2163872 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $19K |
| MAUREEN DOHERTY EIN 04-2163872 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $18K |
| MARY WARDROP EIN 04-2163872 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $15K |
| LANGAN & DEMPSEY EIN 04-2125930 NONE | Legal; Direct payment from the plan Service code 29 | — | $12K |
| ANN BRODERICK EIN 04-2163872 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $9K |
| DAVIS VISION EIN 11-3051991 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $8K |
| IRON MOUNTAIN RECORDS MANAGEMENT EIN 04-3038590 NONE | Direct payment from the plan; Other services Service code 49 | — | $7K |
| OPTUM EIN 62-1451147 NONE | Direct payment from the plan; Other commissions Service code 50 | — | $6K |
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 | 1,428 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 122 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 26 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,576 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,428 | $29K |
| Life insurance | AETNA | 1,487 | $102K |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,487 | $109K |
| Stop-loss / reinsurancereinsurance | UNION LABOR LIFE INSURANCE COMPANY | 1,574 | $329K |
| Other | AETNA | 1,487 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,574 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.