| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET BRAINTREE, MA 02184 | HEALTH NEW ENGLAND | $35K | — | $35K | 2.79% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET SUITE 400 BRAINTREE, MA 02184 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $454 | $4K | 11.23% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET SUITE 400 BRAINTREE, MA 02184 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $459 | $3K | 11.72% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET BRAINTREE, MA 02184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $323 | — | $323 | 2.83% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET SUITE 400 BRAINTREE, MA 02184 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $185 | $1K | 11.73% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET BRAINTREE, MA 02184 | EYEMED VISION CARE (ON BEHALF OF FIDELITY SECURITY LIFE INS. CO.) | $840 | — | $840 | 9.92% |
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 | 217 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NEW ENGLAND | 149 | $1.2M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 322 | $0 |
| Vision | EYEMED VISION CARE (ON BEHALF OF FIDELITY SECURITY LIFE INS. CO.) | 142 | $8K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 217 | $11K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 73 | $31K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 217 | $27K |
| Other(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 217 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 322 | — |
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.