| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC | 400 WASHINGTON ST SUTIE 400 BRAINTREE, MA 02184 | UNITED HEALTH CARE | $44K | $12K | $56K | 2.68% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | EQUITABLE | $4K | — | $4K | 10.82% |
| INDIGO INSURANCE SERVICES3 | 401 PARK DR BOSTON, MA 02215 | EQUITABLE | — | $2K | $2K | 4.99% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET SUITE 400 BRAINTREE, MA 02184 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | $1K | — | $1K | 9.91% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | EQUITABLE | $1K | — | $1K | 90.40% |
| INDIGO INSURANCE SERVICES3 | 401 PARK DR BOSTON, MA 02215 | EQUITABLE | — | $427 | $427 | 30.13% |
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 | 279 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 279 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTH CARE | 279 | $2.1M |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | 99 | $13K |
| Life insurance | EQUITABLE | 153 | $1K |
| Long-term disability | EQUITABLE | 154 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 279 | — |
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.