| 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 | $37K | — | $37K | 2.40% |
| EDAN E. BARSHAN3 Filed as: EDAN BARSHAN | 20 PARK PLAZA - 4TH FLOOR BOSTON, MA 02216 | HARVARD PILGRIM HEALTH CARE INSURANCE COMPANY | $13 | — | $13 | 0.00% |
| 360 CORPORATE BENEFIT ADVISORS3 | 1375 KINGS HIGHWAY E-SUITE 215 FAIRFIELD, CT 06824 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | $5K | $19K | 13.55% |
| 360 CORPORATE BENEFIT ADVISORS3 | 1375 KINGS HIGHWAY E, SUITE 215 FAIRFIELD, CT 06824 | HARTFORD LIFE AND ACCIDENT | $8K | $3K | $12K | 16.91% |
| EDAN E. BARSHAN3 | 20 PARK PLAZA-4TH FLOOR BOSTON, MA 02216 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $224 | — | $224 | 3.74% |
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 | 187 | 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) | 189 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE INSURANCE COMPANY | 235 | $1.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $143K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 144 | $143K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 187 | $70K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 16 | $6K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 187 | $70K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 187 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.