| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GREYLOCK INSURANCE AGENCY | 5 CHESHIRE ROAD PITTSFIELD, MA 01201 | HEALTH NEW ENGLAND | $113K | — | $113K | 4.16% |
| GREYLOCK INSURANCE AGENCY | 5 CHESHIRE ROAD PO BOX 603 PITTSFIELD, MA 01201 | CIGNA HEALTH AND LIFE INSURANCE CO | $3K | — | $3K | 1.96% |
| GREYLOCK INSURANCE AGENCY | 5 CHESHIRE ROAD PO BOX 603 PITTSFIELD, MA 01201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | — | $14K | 10.00% |
| GREYLOCK INSURANCE AGENCY | 5 CHESHIRE ROAD PO BOX 603 PITTSFIELD, MA 01201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 11.94% |
| GREYLOCK INSURANCE AGENCY | 5 CHESHIRE ROAD PO BOX 603 PITTSFIELD, MA 01201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 15.00% |
| GREYLOCK INSURANCE AGENCY | 5 CHESHIRE ROAD PO BOX 603 PITTSFIELD, MA 01201 | VISION SERVICE PLAN | $1K | — | $1K | 4.83% |
| GREYLOCK INSURANCE AGENCY | 5 CHESHIRE ROAD PO BOX 603 PITTSFIELD, MA 01201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $177 | — | $177 | 12.01% |
No Schedule C service providers reported on this filing.
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 | 425 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE CO | 277 | $152K |
| Vision | VISION SERVICE PLAN | 200 | $28K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 376 | $53K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 379 | $136K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 425 | $50K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 377 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 425 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.