| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 115 FEDERAL STREET BOSTON, MA 02110 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $58K | $14K | $72K | 2.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | $0 | $13K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $4K | $4K | 1.60% |
| PLANSOURCE BENEFIT ADMINISTRATION3 | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $4K | $1K | $6K | 2.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | $0 | $17K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 1.60% |
| PLANSOURCE BENEFIT ADMINISTRATION3 | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 1.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: THE MELTZER GROUP, INC. | 6500 ROCK SPRING DRIVE, SUITE 500 BETHESDA, MD 20817 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $4K | $603 | $5K | 2.49% |
| POTOMAC BASIN GROUP ASSOCIATES LLC5 Filed as: POTOMAC BASIN GROUP ASSOC., LLC | 4740 CORRIDOR PLACE, SUITE B BELTSVILLE, MD 20705 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $0 | $2K | $2K | 0.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE, 13TH FLOOR BOSTON, MA 02210 | ZURICH AMERICAN INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE, 10TH FLOOR BOSTON, MA 02116 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 10.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE, 10TH FLOOR BOSTON, MA 02116 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $388 | $39 | $427 | 16.52% |
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 | 256 | 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) | 257 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 257 | $3.5M |
| Dental(2 contracts, 2 carriers) | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 359 | $419K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 313 | $16K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 249 | $214K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 256 | $265K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 257 | $3.5M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 256 | $501K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 359 | — |
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."
No prospect flags tripped on this filing.