| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE HEALTH SOLUTIONS INC | 184 WORCESTER PROVIDENCE TNPK SUTTON, MA 01590 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | $20K | — | $20K | 10.00% |
| SMALL BUSINESS INSURANCE AGENCY3 Filed as: SMALL BUSINESS INS AGCY IN | 542 MAIN STREET WORCESTER, MA 01608 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 04-1045815 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $847K |
| R. REED EIN 04-2219623 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $153K |
| FALLON HEALTH AND LIFE INSURANCE CO EIN 04-3169246 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $94K |
| MANZI & ASSOCIATES LLC EIN 04-3508036 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $72K |
| L. O'KEEFE EIN 04-2219623 PLAN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| CONGRESS WEALTH MANAGEMENT EIN 04-2848965 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $63K |
| N. GODIN EIN 04-2219623 PLAN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $54K |
| C. SCHIAVONE EIN 04-2219623 PLAN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $52K |
| D. ROBERGE EIN 04-2219623 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $52K |
| A. FRIEDMAN EIN 04-2219623 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $43K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC EIN 23-2182079 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $40K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $40K |
| SUNSET LANDSCAPING NONE | Other services; Direct payment from the plan Service code 49 | 173 HENSHAW ST LEICESTER, MA 01524 | $33K |
| CLEARVIEW CLEANING INC NONE | Direct payment from the plan; Other services Service code 49 | PO BOX 523 HOLDEN, MA 01520 | $30K |
| TPG HEALTHCARE CONSULTING EIN 20-8069824 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $20K |
| BOSTON BENEFIT PARTNERS EIN 04-3422351 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $12K |
| PETER J. RIEMER LLC EIN 83-0366061 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $11K |
| UNION BANK & TRUST EIN 41-1267434 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $10K |
| C. MANIERO JANSON NONE | Other services; Direct payment from the plan Service code 49 | 22 MEADOW LANE SWANSEA, MA 02777 | $9K |
| DAVIS VISION EIN 11-3051991 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $7K |
| INTERCONTINENTAL REAL ESTATE EIN 04-3613055 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $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 | 1,352 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 99 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,451 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 1,348 | $201K |
| Stop-loss / reinsurancereinsurance | ACE AMERICAN INSURANCE COMPANY | 1,451 | $213K |
| Other | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 1,451 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,451 | — |
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."
No prospect flags tripped on this filing.