| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MA, INC. | $36K | — | $36K | 2.20% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MA, INC. | — | $13K | $13K | 0.79% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA LLC | 980 WASHINGTON ST STE 325 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $4K | — | $4K | 5.01% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 100 FRONT STREET 20TH FLOOR WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $4K | $4K | 7.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $4K | — | $4K | 5.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA INC. | 100 RIALTO PLACE STE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | — | $779 | $779 | 1.23% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $4K | — | $4K | 9.98% |
| INDIGO INSURANCE SERVICES3 | 100 FRONT STREET 20TH FLOOR WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $3K | $3K | 7.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA INC. | 100 RIALTO PLACE STE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | — | $525 | $525 | 1.27% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $4K | — | $4K | 15.00% |
| INDIGO INSURANCE SERVICES3 | 100 FRONT STREET 20TH FLOOR WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 7.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA INC. | 100 RIALTO PLACE STE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | — | $360 | $360 | 1.26% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN DBA HAYS COMPANIES | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $506 | — | $506 | 6.42% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN DBA HAYS COMPANIES | 133 FEDERAL STREET BOSTON, MA 02110 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $348 | — | $348 | 4.42% |
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 | 194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MA, INC. | 194 | $1.6M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 192 | $86K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 236 | $8K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 175 | $63K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 63 | $29K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 174 | $41K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MA, INC. | 194 | $1.6M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 176 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 236 | — |
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.