| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | HCC LIFE INSURANCE COMPANY | $33K | — | $33K | 7.00% |
| FRED C. CHURCH INC.3 Filed as: FRED C. CHURCH, INC. | 41 WELLMAN STREET LOWELL, MA 01851 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $109 | $3K | 3.76% |
| INDIGO INSURANCE SERVICES3 | 101 HUNTINGTON AVE. BOSTON, MA 02199 | USABLE LIFE | $6K | — | $6K | 20.00% |
| INDIGO INSURANCE SERVICES3 | 101 HUNTINGTON AVE. BOSTON, MA 02199 | USABLE LIFE | $5K | — | $5K | 21.48% |
| INDIGO INSURANCE SERVICES3 | 101 HUNTINGTON AVE BOSTON, MA 02199 | USABLE LIFE | $3K | — | $3K | 18.10% |
| INDIGO INSURANCE SERVICES3 | 101 HUNTINGTON AVE BOSTON, MA 02199 | USABLE LIFE | $4K | — | $4K | 25.00% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | EYEMED | $1K | — | $1K | 8.38% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET LOWELL, MA 01851 | WEST HEALTH ADVOCATE SOLUTIONS, INC. | $77 | — | $77 | 4.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH PLANS, INC. EIN 04-2734278 THIRD PARTY ADMINISTRATOR | Other services; Claims processing Service code 12 | 1500 WEST PARK DRIVE WESTBOROUGH, MA 01581 | $48K |
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 | 128 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WEST HEALTH ADVOCATE SOLUTIONS, INC. | 128 | $2K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 79 | $88K |
| Vision | EYEMED | 188 | $12K |
| Life insurance | USABLE LIFE | 128 | $17K |
| Short-term disability | USABLE LIFE | 128 | $22K |
| Long-term disability | USABLE LIFE | 80 | $28K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 75 | $477K |
| Other(2 contracts) | USABLE LIFE | 128 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.