| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | UNKNOWN CAMBRIDGE, MA 02140 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $18K | $9K | $27K | 2.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $8K | — | $8K | 0.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE BOSTON, MA 02116 | DELTA DENTAL OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $2K | — | $2K | 3.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | DELTA DENTAL OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $1K | $111 | $1K | 2.45% |
| LONGFELLOW FINANCIAL LLC3 Filed as: LONGFELLOW FINANCIAL | 116 HUNTINGTON AVENUE, 10TH FLOOR BOSTON, MA 02116 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $5K | — | $5K | 13.91% |
| INDIGO INSURANCE SVC3 Filed as: INDIGO INSURANCE SERVICE | 446 MAIN STREET, 5TH FLOOR WORCESTER, MA 01608 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $3K | — | $3K | 7.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $45 | — | $45 | 0.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2245 TEXAS DRIVE, SUITE 140 SUGAR LAND, TX 77479 | AMERICAN GENERAL LIFE INSURANCE COMPANY | -$16 | — | -$16 | -0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE, 10TH FLOOR BOSTON, MA 02116 | EYEMED | $359 | — | $359 | 6.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | EYEMED | $218 | — | $218 | 3.66% |
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 | 153 | 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) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 176 | $970K |
| Dental | DELTA DENTAL OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 91 | $51K |
| Vision | EYEMED | 90 | $6K |
| Short-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 153 | $38K |
| Long-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 153 | $38K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 176 | $970K |
| Other | AMERICAN GENERAL LIFE INSURANCE COMPANY | 153 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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.