| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EASTERN BENEFITS GROUP3 | PO BOX 4000 WAKEFIELD, MA 01880 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $57K | $19K | $76K | 2.65% |
| EASTERN BENEFITS GROUP3 | 233 WEST CENTRAL STREET NATICK, MA 01760 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $1K | $8K | 13.21% |
| CLEARY INSURANCE, INC.3 Filed as: CLEARY INSURANCE INC. | 226 CAUSEWAY STREET, SUITE 302 BOSTON, MA 02114 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 3.05% |
| STEPHEN CORRIVEAU3 | 420 GRANGE ROAD NORTH SMITHFIELD, RI 02896 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $795 | $0 | $795 | 2.06% |
| PATRICIA DASILVA3 | 22A TAMARAC DRIVE SMITHFIELD, RI 02828 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $414 | $0 | $414 | 1.07% |
| MELISSA J LINDSEY3 Filed as: MELISSA J. LINDSEY | 152 HARRIS ROAD SMITHFIELD, RI 02917 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $319 | $0 | $319 | 0.83% |
| MJ INSURANCE3 Filed as: JASON C. SHAPIRO AND VARIOUS AGENTS | 41 BRENTON STREET LITCHFIELD, NH 03052 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $280 | $0 | $280 | 0.73% |
| ENROLLMENT SOLUTIONS LTD3 | 65 BURBANK ROAD SUTTON, MA 01590 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $173 | $0 | $173 | 0.45% |
| FLEURY ENTERPRISES INC3 Filed as: FLEURY ENTERPRISES INC. | 162 INDIAN POINT ROAD TIVERTON, RI 02878 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $164 | $0 | $164 | 0.42% |
| EASTERN BENEFITS GROUP3 | PO BOX 4000 WAKEFIELD, MA 01880 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 9.91% |
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 | 406 | 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) | 406 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 391 | $2.9M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 391 | $2.9M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 267 | $21K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 406 | $58K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 406 | $58K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 406 | $58K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 391 | $2.9M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 600 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 600 | — |
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.