| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | HARVARD PILGRIM HEALTH CARE | $22K | — | $22K | 1.80% |
| MICHAEL P TSOTSIS3 | — | HARVARD PILGRIM HEALTH CARE | $82 | — | $82 | 0.01% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | HARVARD PILGRIM HEALTH CARE | $12K | — | $12K | 1.80% |
| MICHAEL P TSOTSIS3 | — | HARVARD PILGRIM HEALTH CARE | $47 | — | $47 | 0.01% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | ALTUS DENTAL INSURANCE COMPANY, INC | $4K | — | $4K | 4.65% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | 160 FEDERAL STREET 2ND FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | — | $12K | 15.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | 160 FEDERAL STREET 2ND FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 15.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | ALTUS DENTAL INSURANCE COMPANY, INC. | $2K | — | $2K | 4.65% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | 160 FEDERAL STREET 2ND FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 15.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC BROKERAGE, INC. | 160 FEDERAL STREET FLOOR 2 BOSTON, MA 02110 | VISION SERVICE PLAN | $601 | — | $601 | 8.57% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | 160 FEDERAL STREET 2ND FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $245 | — | $245 | 14.98% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | HARVARD PILGRIM HEALTH CARE | $0 | — | $0 | — |
| MICHAEL P TSOTSIS3 | — | HARVARD PILGRIM HEALTH CARE | $0 | — | $0 | — |
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 | 335 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 57 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 393 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | HARVARD PILGRIM HEALTH CARE | 201 | $1.9M |
| Dental(2 contracts) | ALTUS DENTAL INSURANCE COMPANY, INC | 219 | $132K |
| Vision | VISION SERVICE PLAN | 56 | $7K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 335 | $36K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 100 | $59K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 315 | $78K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 335 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 335 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.