| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 360 CORPORATE BENEFIT ADVISORS3 | 1375 KINGS HIGHWAY E-SUITE 215 FAIRFIELD, CT 06824 | HARVARD PILGRIM HEALTH CARE INSURANCE COMPANY | $25K | — | $25K | 1.87% |
| EDAN E. BARSHAN3 Filed as: EDAN BARSHAN | 20 PARK PLAZA - 4TH FLOOR BOSTON, MA 02216 | HARVARD PILGRIM HEALTH CARE INSURANCE COMPANY | $4K | — | $4K | 0.33% |
| 360 CORPORATE BENEFIT ADVISORS3 | 1375 KINGS HIGHWAY E-SUITE 215 FAIRFIELD, CT 06824 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.42% |
| EDAN E. BARSHAN3 Filed as: EDAN BARSHAN | 8 WHITTIER PLACE-#24B BOSTON, MA 02214 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.79% |
| 360 CORPORATE BENEFIT ADVISORS3 | 1375 KINGS HIGHWAY E-SUITE 215 FAIRFIELD, CT 06824 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $440 | $4K | 5.26% |
| EDAN E. BARSHAN3 Filed as: EDAN E BARSHAN | 20 PARK PLAZA - 4TH FLOOR BOSTON, MA 02216 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 4.68% |
| EDAN E. BARSHAN3 Filed as: EDAN E BARSHAN | 20 PARK PLAZA - 4TH FLOOR BOSTON, MA 02216 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $766 | — | $766 | 10.26% |
| UNIVERSAL INSURANCE ADVISORS INC3 Filed as: UNIVERSAL BENEFIT PLANS INC. | 20 PARK PLAZA - 4TH FLOOR BOSTON, MA 02216 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $279 | — | $279 | 6.84% |
| 360 CORPORATE BENEFIT ADVISORS3 | 1375 KINGS HIGHWAY E, SUITE 215 FAIRFIELD, CT 06824 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $178 | $9 | $187 | 4.58% |
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 | 174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE INSURANCE COMPANY | 214 | $1.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 145 | $124K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 174 | $88K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 28 | $7K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 174 | $84K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 174 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.