| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLARK INSURANCE3 Filed as: CLARK & LAVEY BENEFITS SOLUTIONS | 7 HENRY CLAY DRIVE MERRIMACK, NH 03054 | BLUE CROSS BLUE SHIELD OF MA | $14K | $0 | $14K | 2.38% |
| JOHN FRANK SIRACUSA3 Filed as: JOHN SIRACUSA | 129 MOUNT AUBURN STREET CAMBRIDGE, MA 02138 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | $0 | $17K | 8.77% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY, SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $2K | $14K | 7.07% |
| JOHN FRANK SIRACUSA3 Filed as: JOHN SIRACUSA | 129 MOUNT AUBURN STREET CAMBRIDGE, MA 02138 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 9.30% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PKWY, SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $701 | $93 | $794 | 6.46% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC | 200 GALLERIA PKWY, SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $506 | $0 | $506 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE BENEFIT ADMINISTRATORS OF MA THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | P.O. BOX 55917 BOSTON, MA 02205 | $352K |
| CLARK & LAVEY BENEFITS SOLUTIONS EIN 04-3348257 BROKER/CONSULTANT | Other commissions Service code 55 | 7 HENRY CLAY DRIVE MERRIMACK, NH 03054 | $337K |
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 | 644 | 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) | 644 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD OF MA | 1,355 | $583K |
| Life insurance(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 537 | $211K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE | 652 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,355 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.