| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRIAN M RAVENELLE3 | 351 MAIN STREET OXFORD, MA 01540 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | — | $19K | $19K | 10.00% |
| BRIAN M RAVENELLE3 | 351 MAIN STREET OXFORD, MA 01540 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | — | $1K | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 04-1045815 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $870K |
| R. REED EIN 04-2219623 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $162K |
| FALLON HEALTH AND LIFE INSURANCE CO EIN 04-3169246 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $92K |
| S. MARRINO EIN 04-2219623 PLAN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $87K |
| CONGRESS WEALTH MANAGEMENT EIN 04-2848965 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $86K |
| L. O'KEEFE EIN 04-2219623 PLAN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $70K |
| N. GODIN EIN 04-2219623 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| C. SCHIAVONE EIN 04-2219623 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $56K |
| MANZI & ASSOCIATES LLC EIN 04-3508036 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $56K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $42K |
| A. FRIEDMAN EIN 04-2219623 PLAN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $42K |
| 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 | — | $37K |
| TPG HEALTHCARE CONSULTING EIN 20-8069824 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $34K |
| SUNSET LANDSCAPING NONE | Other services; Direct payment from the plan Service code 49 | 173 HENSHAW ST LEICESTER, MA 01524 | $31K |
| AQUARIUS CAPITAL SOLUTIONS GROUP EIN 32-0020166 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $20K |
| UNION BANK & TRUST EIN 41-1267434 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $13K |
| BOSTON BENEFIT PARTNERS EIN 04-3422351 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $13K |
| 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; Investment management fees paid directly by plan Service code 28 | — | $7K |
| GEORGE RUSSELL REALTY LLC EIN 56-2369260 NONE | Real estate brokerage; Direct payment from the plan Service code 32 | — | $5K |
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 | 1,344 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 82 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,426 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 1,325 | $191K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE LIFE INSURANCE COMPANY | 1,426 | $230K |
| Other | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 1,325 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,426 | — |
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.