| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EASTERN BENEFITS GROUP3 | 607 NORTH AVENUE WAKEFIELD, MA 01880 | TUFTS INSURANCE COMPANY | $24K | $13K | $38K | 3.19% |
| EASTERN BENEFITS GROUP3 | 607 NORTH AVENUE WAKEFIELD, MA 01880 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | $19K | $11K | $30K | 3.20% |
| EASTERN BENEFITS GROUP3 | PO BOX 4000 WAKEFIELD, MA 01880 | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $4K | $0 | $4K | 2.00% |
| EASTERN BENEFITS GROUP3 | PO BOX 4000 WAKEFIELD, MA 01880 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 7.80% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $49 | $49 | 0.04% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $21 | $21 | 0.02% |
| EASTERN BENEFITS GROUP3 | 233 WEST CENTRAL STREET NATICK, MA 01760 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $833 | $11K | 21.87% |
| EASTERN BENEFITS GROUP3 | PO BOX 4000 WAKEFIELD, MA 01880 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 9.84% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICE INC. | 400 WASHINGTON STREET, SUITE 400 BRAINTREE, MA 02184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $88 | $0 | $88 | 1.37% |
| EASTERN BENEFITS GROUP3 | 233 WEST CENTRAL STREET NATICK, MA 01760 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $60 | $0 | $60 | 0.93% |
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 | 259 | 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) | 259 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TUFTS INSURANCE COMPANY | 183 | $2.1M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 360 | $176K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 271 | $18K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 259 | $171K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 259 | $122K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 259 | $122K |
| Prescription drug(2 contracts, 2 carriers) | TUFTS INSURANCE COMPANY | 183 | $2.1M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 259 | $177K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 360 | — |
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."
No prospect flags tripped on this filing.