| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE GRP OF NE | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | HARVARD PILGRIM HEALTH CARE | $23K | — | $23K | 1.72% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA, LLC | 300 N BEACH STREET DAYTONA BEACH, FL 32114 | HARVARD PILGRIM HEALTH CARE | $17K | — | $17K | 1.25% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN&BROWN INSURANCE SERVICES, INC | 980 WASHINGTON STREET DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE | $0 | $10K | $10K | 0.75% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVS, INC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | $2K | — | $2K | 3.15% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | $695 | — | $695 | 1.02% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA, LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, WI 02026 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $912 | — | $912 | 3.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN&BROWN INSURANCE SERVICES, INC | 1200 N MAYFAIR ROAD SUITE 100 MILWAUKEE, WI 53226 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $272 | $272 | 0.90% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN&BROWN INSURANCES SERVICES INC | 1200 N MAYFAIR ROAD SUITE 100 MILWAUKEE, WI 53226 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $249 | $249 | 0.88% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $796 | — | $796 | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES IN | 1200 N MAYFAIR ROAD SUITE 100 MILWAUKEE, WI 53226 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $74 | $74 | 0.93% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN DBA HAYS COMPANIES | 980 WASHINGTON ST. SUITE 325 DEDHAM, MA 02026 | FIDELITY SECURITY LIFE INSURANCE COMPANY; EYEMED VISION CARE | $510 | — | $510 | 7.94% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | FIDELITY SECURITY LIFE INSURANCE COMPANY; EYEMED VISION CARE | $117 | — | $117 | 1.82% |
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 | 99 | 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) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 138 | $1.3M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | 143 | $68K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY; EYEMED VISION CARE | 91 | $6K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 99 | $28K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 99 | $8K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 99 | $30K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE | 138 | $1.3M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 99 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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.