| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | ONE MONARCH PLACE, SUITE 1500 SPRINGFIELD, MA 01144 | HEALTH NEW ENGLAND, INC. | $41K | $0 | $41K | 3.48% |
| NORTHERN BENEFITS OF MA3 | 47 MAPLE STREET, SUITE 150 BURLINGTON, VT 05401 | ALTUS DENTAL INSURANCE COMPANY, INC. | $2K | $0 | $2K | 2.00% |
| SCHUSTER DRISCOLL LLC3 | 135 SOUTH ROAD FARMINGTON, CT 06032 | ALTUS DENTAL INSURANCE COMPANY, INC. | $2K | $0 | $2K | 2.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | UNKNOWN MORRIS, IL 60450 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 4.72% |
| NORTHERN BENEFITS OF MA3 | 47 MAPLE STREET, SUITE 150 BURLINGTON, VT 05401 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 4.09% |
| SCHUSTER DRISCOLL LLC3 | 135 SOUTH ROAD FARMINGTON, CT 06032 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 4.09% |
| NORTHERN BENEFITS OF MA3 | 5 MOUNT ROYAL AVENUE, SUITE 210 MARLBOROUGH, MA 01752 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $202 | $0 | $202 | 5.00% |
| SCHUSTER DRISCOLL LLC3 | 135 SOUTH ROAD FARMINGTON, CT 06032 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $202 | $0 | $202 | 5.00% |
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 | 142 | 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) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NEW ENGLAND, INC. | 88 | $1.2M |
| Dental | ALTUS DENTAL INSURANCE COMPANY, INC. | 187 | $90K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 54 | $4K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 142 | $50K |
| Short-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 142 | $50K |
| Prescription drug | HEALTH NEW ENGLAND, INC. | 88 | $1.2M |
| Other | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 142 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.