| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | HARVARD PILGRIM HEALTH CARE | $30K | — | $30K | 2.58% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | HARVARD PILGRIM HEALTHCARE | $6K | — | $6K | 2.58% |
| HPHC INSURANCE AGENCY, INC.3 Filed as: HPHC INSURANCE AGENCY, INC | — | GUARDIAN | $6K | — | $6K | 6.00% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | GUARDIAN | $3K | — | $3K | 3.61% |
| BULFINCH GROUP INSURANCE AGENCY3 | — | GUARDIAN | $257 | — | $257 | 0.27% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | MONY LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 15.91% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE | 446 MAIN ST 5TH FLOOR WORCESTER, MA 01608 | MONY LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 8.58% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | EYEMED VISION CARE | $957 | — | $957 | 9.80% |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 141 | $1.4M |
| Dental | GUARDIAN | 99 | $95K |
| Vision | EYEMED VISION CARE | 126 | $10K |
| Life insurance | MONY LIFE INSURANCE COMPANY OF AMERICA | 117 | $32K |
| Short-term disability | MONY LIFE INSURANCE COMPANY OF AMERICA | 117 | $32K |
| Long-term disability | MONY LIFE INSURANCE COMPANY OF AMERICA | 117 | $32K |
| Other(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 141 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.