| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS INC | 144 THURNPIKE RD STE 350 SOUTHBOROUGH, MN 01772 | SUNLIFE ASSURANCE COMPANY OF CANADA | $38K | — | $38K | 3.52% |
| 21ST CENTURY BENEFIT & INS3 Filed as: 21ST CENTURY BENEFIT & INS BROKERAG | 2 PARK CENTRAL DR STE 120 SOUTHBOROUGH, MA 01772 | SUNLIFE ASSURANCE COMPANY OF CANADA | $27K | — | $27K | 2.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA HEALTH INC EIN 23-2442048 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $1.5M |
| KAISER PERMANENT MID-ATLANTIC EIN 52-0854463 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $1.3M |
| BLUECROSS BLUESHIELD OF MA EIN 04-1045815 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $878K |
| HARVARD PILGRIM HEALTH CARE EIN 04-2452600 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $522K |
| PRICEWATERCOOPERS LLP EIN 13-4008324 ACTURIAL | Actuarial Service code 11 | — | $62K |
| FEELEY & DRISCOLL EIN 04-2684828 AUDITORS | Accounting (including auditing) Service code 10 | — | $29K |
| PNC ADVISORS EIN 43-0133403 INVESTMENT MANAGER | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $26K |
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 | 5,617 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 177 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,794 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | SUNLIFE ASSURANCE COMPANY OF CANADA | 5,624 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,624 | — |
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.