| 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 | $40K | — | $40K | 2.99% |
| EDAN E. BARSHAN3 Filed as: EDAN BARSHAN | 20 PARK PLAZA - 4TH FLOOR BOSTON, MA 02216 | HARVARD PILGRIM HEALTH CARE INSURANCE COMPANY | $55 | — | $55 | 0.00% |
| 360 CORPORATE BENEFIT ADVISORS3 | 1375 KINGS HIGHWAY E-SUITE 215 FAIRFIELD, CT 06824 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 10.00% |
| 360 CORPORATE BENEFIT ADVISORS3 | 1375 KINGS HIGHWAY E-SUITE 215 FAIRFIELD, CT 06824 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $576 | $7K | 9.32% |
| EDAN E. BARSHAN3 Filed as: EDAN E BARSHAN | 20 PARK PLAZA - 4TH FLOOR BOSTON, MA 02216 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $560 | — | $560 | 7.94% |
| 360 CORPORATE BENEFIT ADVISORS3 | 1375 KINGS HIGHWAY E, SUITE 215 FAIRFIELD, CT 06824 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $742 | $37 | $779 | 20.49% |
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 | 186 | 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) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE INSURANCE COMPANY | 222 | $1.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 152 | $125K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 186 | $80K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 25 | $7K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 186 | $76K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 186 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 222 | — |
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.