| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS AND GRAY INS. AGENCY, INC. | 434 ROUTE 134, SUITE F1 SOUTH DENNIS, MA 02660 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | $34K | $12K | $46K | 2.47% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $4K | $16K | 18.24% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 3.87% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS AND GRAY INS. AGENCY, INC. | 434 ROUTE 134, SUITE F1 SOUTH DENNIS, MA 02660 | SYMETRA LIFE INSURANCE COMPANY | $4K | — | $4K | 12.41% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS AND GRAY INS. AGENCY, INC. | 434 ROUTE 134, SUITE F1 SOUTH DENNIS, MA 02660 | TUFTS INSURANCE COMPANY | $590 | $131 | $721 | 2.47% |
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 | 221 | 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) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | 239 | $1.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 160 | $90K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 160 | $90K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 221 | $124K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 160 | $90K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 221 | $34K |
| Prescription drug(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | 239 | $1.9M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 221 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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.