| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $187K | $52K | $238K | 2.30% |
| VIATOR INTERNATIONAL LLC3 Filed as: VIATOR INTERNATIONAL, LLC | UNKNOWN WALTHAM, MA 02451 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $27K | $0 | $27K | 5.60% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $34K | $0 | $34K | 7.78% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 15.00% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 7.00% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 199 WATER STREET, 12TH FLOOR NEW YORK, NY 10038 | HARTFORD LIFE AND ACCIDENT | $4K | $44 | $5K | 30.30% |
| VIATOR INTERNATIONAL LLC3 Filed as: VIATOR INTERNATIONAL, LLC | UNKNOWN WALTHAM, MA 02451 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
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 | 470 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 478 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 956 | $10.8M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 46 | $475K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 715 | $47K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 470 | $434K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 470 | $434K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 956 | $10.4M |
| Other(5 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 470 | $992K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 956 | — |
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.