| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET BRAINTREE, MA 02184 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $39K | $10K | $49K | 2.26% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET BRAINTREE, MA 02184 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $6K | — | $6K | 3.37% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | MONY LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 6.50% |
| INDIGO INSURANCE SERVICES3 | 446 MAIN ST 5TH FLOOR WORCESTER, MA 01608 | MONY LIFE INSURANCE COMPANY OF AMERICA | — | $6K | $6K | 6.50% |
| INDIGO INSURANCE SERVICES3 | 446 MAIN ST 5TH FLOOR WORCESTER, MA 01608 | MONY LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 6.51% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | MONY LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.58% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | MONY LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 12.54% |
| INDIGO INSURANCE SERVICES3 | 446 MAIN ST 5TH FLOOR WORCESTER, MA 01608 | MONY LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 6.50% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE C | $1K | — | $1K | 9.26% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | MONY LIFE INSURANCE COMPANY OF AMERICA | $623 | — | $623 | 9.21% |
| INDIGO INSURANCE SERVICES3 | 446 MAIN ST 5TH FLOOR WORCESTER, MA 01608 | MONY LIFE INSURANCE COMPANY OF AMERICA | — | $436 | $436 | 6.44% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.99% |
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 | 153 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 287 | $2.2M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 290 | $169K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE C | 155 | $12K |
| Life insurance | MONY LIFE INSURANCE COMPANY OF AMERICA | 153 | $31K |
| Short-term disability | MONY LIFE INSURANCE COMPANY OF AMERICA | 153 | $96K |
| Long-term disability | MONY LIFE INSURANCE COMPANY OF AMERICA | 152 | $27K |
| Other(2 contracts, 2 carriers) | MONY LIFE INSURANCE COMPANY OF AMERICA | 12 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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.