| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $58K | $14K | $72K | 2.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $9K | $0 | $9K | 3.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE, 10TH FLOOR BOSTON, MA 02116 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $0 | $12K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 1.25% |
| PLANSOURCE BENEFIT ADMINISTRATION3 | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 0.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE, 10TH FLOOR BOSTON, MA 02116 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $0 | $16K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 1.25% |
| PLANSOURCE BENEFIT ADMINISTRATION3 | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $991 | $0 | $991 | 0.50% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: THE MELTZER GROUP, INC. | 6500 ROCK SPRING DRIVE, SUITE 500 BETHESDA, MD 20817 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $3K | $2K | $5K | 3.12% |
| POTOMAC BASIN GROUP ASSOCIATES LLC5 Filed as: POTOMAC BASIN GROUP ASSOCIATES, LLC | 4740 CORRIDOR PLACE, SUITE B BELTSVILLE, MD 20705 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $0 | $2K | $2K | 1.03% |
| LONGFELLOW FINANCIAL LLC3 Filed as: LONGFELLOW FINANCIAL, LLC | 116 HUNTINGTON AVENUE BOSTON, MA 02116 | ZURICH AMERICAN INSURANCE COMPANY | $3K | $0 | $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 | 10.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE BOSTON, MA 02116 | HARTFORD LIFE AND ACCIDENT | $388 | $0 | $388 | 15.01% |
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 | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 261 | 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. | 294 | $3.1M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 410 | $243K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 343 | $18K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 244 | $198K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 256 | $233K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 294 | $3.1M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 256 | $454K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 410 | — |
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.