| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EASTERN BENEFITS GROUP3 | 233 WEST CENTRAL STREET NATICK, MA 01760 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $47K | $10K | $57K | 3.00% |
| ESTATE OF JOHN V. GIARRATANA JR.3 | 222 CAPE POINT CIRCLE JUPITOR, FL 33477 | AMERICAN FIDELITY ASSURANCE COMPANY | $6K | $0 | $6K | 4.27% |
| NEW ENGLAND EMPLOYEE BENEFITS CO3 Filed as: NEW ENGLAND AUTO DEALERS | UNKNOWN EAST BRIDGEWATER, MA 02333 | AMERICAN FIDELITY ASSURANCE COMPANY | $0 | $534 | $534 | 0.36% |
| MSADA3 | UNKNOWN BOSTON, MA 02109 | AMERICAN FIDELITY ASSURANCE COMPANY | $0 | $274 | $274 | 0.18% |
| EASTERN BENEFITS GROUP3 | 233 WEST CENTRAL STREET NATICK, MA 01760 | AMERICAN FIDELITY ASSURANCE COMPANY | $85 | $0 | $85 | 0.06% |
| R L TENNANT INSURANCE AGENCY, INC.3 Filed as: R L TENNANT INSURANCE AGENCY INC. | 1149 WASHINGTON STREET NEWTON, MA 02460 | AMERICAN FIDELITY ASSURANCE COMPANY | $31 | $0 | $31 | 0.02% |
| BRANDON R ROYCE3 Filed as: BRANDON R. ROYCE | 2000 COMMONWEALTH AVENUE SUITE 110 AUBURNDALE, MA 02466 | AFLAC | $1K | $209 | $1K | 7.50% |
| STEVEN R KARAS3 Filed as: STEVEN R. KARAS | 2000 COMMONWEALTH AVENUE, SUITE 110 AUBURNDALE, MA 02466 | AFLAC | $653 | $49 | $702 | 3.52% |
| MJ INSURANCE3 Filed as: DANIEL P. CLARK AND VARIOUS AGENTS | 33 LANDAU ROAD PLAINVILLE, MA 02762 | AFLAC | $329 | $0 | $329 | 1.65% |
| DAVID S HALLETT3 Filed as: DAVID S. HALLETT | 8 BROOKS STREET WINCHESTER, MA 01890 | AFLAC | $199 | $49 | $248 | 1.24% |
| PROCTER AND COMPANY INS. AGENCY3 | 180 WELLS AVENUE, SUITE 301A NEWTON CENTER, MA 02459 | AFLAC | $188 | $0 | $188 | 0.94% |
| MICHAEL P SPEISMAN3 | 5 WEST STREET NATICK, MA 01760 | AFLAC | $141 | $39 | $180 | 0.90% |
| STEPHEN C. HEROUX3 | 2609 PICO PLACE APARTMENT 231 SAN DIEGO, CA 92109 | AFLAC | $101 | $0 | $101 | 0.51% |
| BRANDON R ROYCE3 Filed as: BRANDON R. ROYCE | 2000 COMMONWEALTH AVENUE SUITE 110 AUBURNDALE, MA 02466 | AFLAC | $1K | $47 | $1K | 12.53% |
| STEVEN R KARAS3 Filed as: STEVEN R. KARAS | 2000 COMMONWEALTH AVENUE, SUITE 110 AUBURNDALE, MA 02466 | AFLAC | $401 | $17 | $418 | 4.56% |
| DAVID S HALLETT3 Filed as: DAVID S. HALLETT | 8 BROOKS STREET WINCHESTER, MA 01890 | AFLAC | $192 | $17 | $209 | 2.28% |
| MICHAEL P SPEISMAN3 | 5 WEST STREET NATICK, MA 01760 | AFLAC | $79 | $36 | $115 | 1.25% |
| JOEL B KARAS3 Filed as: JOEL KARAS | 7 SHANLEY STREET APARTMENT 1 BRIGHTON, MA 02135 | AFLAC | $100 | $0 | $100 | 1.09% |
| STEPHEN C. HEROUX3 Filed as: STEPHEN C. HEROUX AND OTHER AGENTS | 2609 PICO PLACE APARTMENT 231 SAN DIEGO, CA 92109 | AFLAC | $97 | $0 | $97 | 1.06% |
| PROCTER AND COMPANY INS. AGENCY3 | 180 WELLS AVENUE, SUITE 301A NEWTON CENTER, MA 02459 | AFLAC | $50 | $0 | $50 | 0.54% |
| AMERICAN FIDELITY GENERAL AGENCY3 | 9000 CAMERON PARKWAY OKLAHOMA CITY, OK 73114 | EYEMED | $1K | $0 | $1K | 18.49% |
| KARIN L. PETERSEN3 | 337 LYNWOOD DRIVE SEVERNA PARK, MD 21146 | AFLAC | $9 | $0 | $9 | 3.80% |
| ADRIANA E. ANDERSON3 | 1 MEGHAN LANE DRACUT, MA 01826 | AFLAC | $5 | $0 | $5 | 2.11% |
| KAREN TUCCI3 | 73 STETSON DRIVE MARBOROUGH, MA 01752 | AFLAC | $4 | $0 | $4 | 1.69% |
| DANIEL P CLARK3 Filed as: DANIEL P. CLARK | 33 LANDAU ROAD PLAINVILLE, MA 02762 | AFLAC | $1 | $0 | $1 | 0.42% |
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 | 169 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 287 | $1.9M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 287 | $1.9M |
| Vision | EYEMED | 72 | $6K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 66 | $149K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 66 | $149K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 287 | $1.9M |
| Other(4 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 169 | $178K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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.