| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SAPERS & WALLACK3 | WASHINGTON STREET SUITE 110 NEWTON, MA 02458 | FALLON COMMUNITY HEALTH PLAN | $34K | — | $34K | 1.78% |
| SAPERS & WALLACK3 | WASHINGTON STREET SUITE 110 NEWTON, MA 02458 | DELTA DENTAL OF MASSACHUSETTS | $11K | — | $11K | 3.55% |
| ROBERT W. HALLOCK3 | 8 GLEASON ROAD SHREWSBURY, MA 01545 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | — | $14K | 12.00% |
| ROBERT W. HALLOCK3 Filed as: ROBERT W HALLOCK | 8 GLEASON ROAD SHREWSBURY, MA 01545 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $5K | — | $5K | 8.10% |
| ROBERT W. HALLOCK3 | 8 GLEASON ROAD SHREWSBURY, MA 01545 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $898 | — | $898 | 15.00% |
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 | 775 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 775 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FALLON COMMUNITY HEALTH PLAN | 389 | $1.9M |
| Dental | DELTA DENTAL OF MASSACHUSETTS | 694 | $324K |
| Life insurance | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 775 | $57K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 775 | $113K |
| Stop-loss / reinsurancereinsurance | AMERICAN NATIONAL INSURANCE COMPANY | 389 | $10K |
| Other | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 775 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 775 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.