| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET BRAINTREE, MA 02184 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | — | $12K | $12K | 0.67% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC. | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | BLUE CROSS BLUE SHIELD OF MA | $5K | — | $5K | 3.72% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET SUITE 400 BRAINTREE, MA 02184 | SYMETRA LIFE INSURANCE COMPANY | $6K | — | $6K | 15.01% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 446 MAIN STREET 5TH FLOOR WORCESTER, MA 01608 | SYMETRA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.00% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET BRAINTREE, MA 02184 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE | $742 | — | $742 | 8.35% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC. | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.00% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC. | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 12.00% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC. | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $54 | — | $54 | 12.00% |
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 | 206 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 237 | $1.8M |
| Dental | BLUE CROSS BLUE SHIELD OF MA | 259 | $134K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE | 139 | $9K |
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 206 | $49K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 206 | $40K |
| Long-term disability(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 206 | $49K |
| Other | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 206 | $450 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 259 | — |
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.