| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE 240 CRANSTON, RI 02920 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $41K | $9K | $50K | 2.12% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE 240 CRANSTON, RI 02920 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $5K | — | $5K | 3.87% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE 240 CRANSTON, RI 02920 | STANDARD INSURANCE COMPANY | $16K | — | $16K | 13.00% |
| ELIOT LAPPEN INS AGENCY INC.3 Filed as: ELIOT LAPPEN INS ANGENCY INC | 1087 BEACON ST., STE. 202 NEWTON CENTER, MA 02459 | STANDARD INSURANCE COMPANY | — | $744 | $744 | 0.61% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE 240 CRANSTON, RI 02920 | STANDARD INSURANCE COMPANY | $13K | — | $13K | 13.00% |
| ELIOT LAPPEN INS AGENCY INC.3 Filed as: ELIOT LAPPEN INS ANGENCY INC | 1087 BEACON ST., STE. 202 NEWTON CENTER, MA 02459 | STANDARD INSURANCE COMPANY | — | $671 | $671 | 0.65% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE 240 CRANSTON, RI 02920 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 13.00% |
| ELIOT LAPPEN INS AGENCY INC.3 Filed as: ELIOT LAPPEN INS ANGENCY INC | 1087 BEACON ST., STE. 202 NEWTON CENTER, MA 02459 | STANDARD INSURANCE COMPANY | — | $297 | $297 | 0.59% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE 240 CRANSTON, RI 02920 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 27.56% |
| ELIOT LAPPEN INS AGENCY INC.3 Filed as: ELIOT LAPPEN INS ANGENCY INC | 1087 BEACON ST., STE. 202 NEWTON CENTER, MA 02459 | STANDARD INSURANCE COMPANY | $443 | $44 | $487 | 6.42% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE 240 CRANSTON, RI 02920 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $405 | — | $405 | 10.00% |
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 MASSACHUSETTS, INC. | 304 | $2.4M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 303 | $123K |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 72 | $4K |
| Life insurance | STANDARD INSURANCE COMPANY | 194 | $122K |
| Short-term disability | STANDARD INSURANCE COMPANY | 191 | $50K |
| Long-term disability | STANDARD INSURANCE COMPANY | 194 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 304 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.