| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS, INC. | 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | AETNA LIFE INSURANCE COMPANY | $34K | — | $34K | 4.42% |
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS | 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $23K | $10K | $34K | 7.20% |
| CAROLYN JOHNSON3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $51K | — | $51K | 11.64% |
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS, INC. | 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | UNITEDHEALTHCARE INSURANCE COMPANY | $14K | — | $14K | 9.97% |
| CAROLYN JOHNSON3 | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 12.16% |
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS, INC. | 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | FEDERAL INSURANCE COMPANY | $412 | — | $412 | 5.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MA EIN 04-1045815 MEDICAL ADMIN | Claims processing Service code 12 | 401 PARK DRIVE BOSTON, MA 02215 | $764K |
| DELTA DENTAL OF MASSACHUSETTS EIN 04-6143185 DENTAL ADMIN | Claims processing Service code 12 | 465 MEDFORD STREET BOSTON, MA 02129 | $108K |
| LIBERTY LIFE ASSURANCE COMPANY OF B EIN 04-6076039 STD ADMIN SERVICES | Contract Administrator; Insurance services; Claims processing; Consulting (general) Service code 12 | — | $69K |
| CVS CAREMARK EIN 05-0340626 RX ADMIN | Claims processing Service code 12 | 200 SPRINGFIELD AVENUE RUTHERFORD, NJ 07070 | $20K |
| STRATEGIC BENEFIT ADVISORS CONSULTANT | Consulting (general) Service code 16 | 144 TURNPIKE ROAD SUITE 330 SOUTHBOROUGH, MA 01772 | $0 |
| STRATEGIC BENEFIT ADVISORS INC. CONSULTANT | Consulting (general) Service code 16 | 144 TURNPIKE ROAD SUITE 330 SOUTHBOROUGH, MA 01772 | $0 |
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 | 1,373 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,373 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH ALLIANCE MEDICAL PLANS | 107 | $2.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 22 | $442K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 2,737 | $140K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,427 | $825K |
| Long-term disability(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,792 | $516K |
| Other(5 contracts, 5 carriers) | AETNA LIFE INSURANCE COMPANY | 4,430 | $888K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,430 | — |
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.