| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EASTERN INSURANCE GROUP LLC3 Filed as: EASTERN INSURANCE GROUP | 607 NORTH AVE PO BOX 4000 WAKEFIELD, MA 01880 | TUFTS HEALTH PLAN | $24K | $8K | $32K | 4.19% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC. | 400 WASHINGTON STREET SUITE 400 BRAINTREE, MA 02184 | TUFTS HEALTH PLAN | — | $24 | $24 | 0.00% |
| EASTERN INSURANCE GROUP LLC3 Filed as: EASTERN INSURANCE GROUP | PO BOX 4000 WAKEFIELD, MA 01880 | TUFTS INSURANCE COMPANY | $10K | $2K | $12K | 3.26% |
| EASTERN INSURANCE GROUP LLC3 Filed as: EASTERN INSURANCE GROUP | PO BOX 4000 WAKEFIELD, MA 01880 | DELTA DENTAL OF MASSACHUSETTS | $4K | $148 | $4K | 4.47% |
| EASTERN INSURANCE GROUP LLC3 | PO BOX 4000 WAKEFIELD, MA 01880 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 10.25% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $58 | $58 | 0.09% |
| EASTERN INSURANCE GROUP LLC3 | 233 W. CENTRAL STREET NATICK, MA 01760 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $305 | $1K | 10.17% |
| EASTERN INSURANCE GROUP LLC3 | 233 W. CENTRAL STREET NATICK, MA 01760 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $928 | — | $928 | 8.51% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICE INC. | 400 WASHINGTON STREET SUITE 400 BRAINTREE, MA 02184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $192 | — | $192 | 1.76% |
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 | 246 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TUFTS HEALTH PLAN | 138 | $1.1M |
| Dental | DELTA DENTAL OF MASSACHUSETTS | 246 | $94K |
| Life insurance(2 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 169 | $79K |
| Short-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 169 | $65K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 169 | $65K |
| Other(3 contracts, 3 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 169 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 246 | — |
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.