| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE GRP OF NE | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE | $22K | — | $22K | 1.69% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA, LLC | 980 WASHINGTON STREET DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE | $16K | — | $16K | 1.22% |
| 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 | $2K | — | $2K | 2.66% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $441 | $4K | 16.72% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA, LLC | 155 FEDERAL STREET SUITE 1500 BOSTON, MA 02110 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $770 | — | $770 | 3.00% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $490 | $3K | 12.06% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $692 | $120 | $812 | 11.73% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN DBA HAYS COMPANIES | 133 FEDERAL STREET 3RD FLOOR BOSTON, MA 02110 | FIDELITY SECURITY LIFE INSURANCE COMPANY; EYEMED VISION CARE | $322 | — | $322 | 5.84% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN DBA HAYS COMPANIES | 980 WASHINGTON STREET DEDHAM, MA 02026 | FIDELITY SECURITY LIFE INSURANCE COMPANY; EYEMED VISION CARE | $138 | — | $138 | 2.50% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 133 FEDERAL STREET 3RD FLOOR BOSTON, MA 02110 | FIDELITY SECURITY LIFE INSURANCE COMPANY; EYEMED VISION CARE | $39 | — | $39 | 0.71% |
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 | 92 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 93 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 139 | $1.3M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | 148 | $71K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY; EYEMED VISION CARE | 76 | $6K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 92 | $24K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 92 | $7K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 92 | $26K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE | 139 | $1.3M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 92 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 148 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.