| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | HARVARD PILGRIM HEALTH CARE | $37K | $0 | $37K | 2.27% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $11K | $0 | $11K | 14.30% |
| USI INSURANCE SERVICES LLC3 | 530 PRESTON AVENUE MERIDEN, CT 06450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $2K | $6K | 8.43% |
| KLINGAMAN & ASSOCIATES, INC.3 Filed as: KLINGAMAN & ASSOCIATES INC | 131 COAL KILN ROAD PRINCETON, MA 01541 | AFLAC | $254 | $0 | $254 | 8.43% |
| WEX INC3 | 11 STOCKDALE ROAD NEEDHAM, MA 02492 | AFLAC | $47 | $0 | $47 | 1.56% |
| DANIEL P CLARK3 Filed as: DANIEL P. CLARK | 33 LANDAU ROAD PLAINVILLE, MA 02762 | AFLAC | $25 | $0 | $25 | 0.83% |
| DAVID S HALLETT3 Filed as: DAVID S. HALLETT | 8 BROOKS STREET WINCHESTER, MA 01890 | AFLAC | $18 | $0 | $18 | 0.60% |
| JOHN B DRZEWIECKI JR3 Filed as: JOHN B. DRZEWIECKI JR. | 370 SOUTHSHIRE DRIVE BENNINGTON, VT 05201 | AFLAC | $9 | $0 | $9 | 0.30% |
| MJ INSURANCE3 Filed as: MARGARET LOCHNER AND VARIOUS AGENTS | 365 WALLOOMSAC ROAD BENNINGTON, VT 05201 | AFLAC | $3 | $0 | $3 | 0.10% |
| MAUREEN E SNOW3 Filed as: MAUREEN E. SNOW | 68 WINGATE ROAD HOLLISTON, MA 01746 | AFLAC | $2 | $0 | $2 | 0.07% |
| ES INC KINGAMAN & ASSOCIATES3 | 131 COAL KILN ROAD PRINCETON, MA 01541 | CONTINENTAL AMERICAN INSURANCE COMPANY | $73 | $0 | $73 | 6.23% |
| TMBG INC3 Filed as: TMBG, INC. | 38 MYRTLE STREET BELMONT, MA 02478 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | $0 | $16 | 1.37% |
| WEX INC3 | 11 STOCKDALE ROAD NEEDHAM, MA 02492 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | $0 | $8 | 0.68% |
| BENEDIKT N MASON3 Filed as: BENEDIKT N. MASON | 17 LITTLE BEAR HILL ROAD WESTFORD, MA 01886 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | $0 | $7 | 0.60% |
| DANIEL P CLARK3 Filed as: DANIEL P. CLARK | 33 LANDAU ROAD PLAINVILLE, MA 02762 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | $0 | $4 | 0.34% |
| MAUREEN E SNOW3 Filed as: MAUREEN E. SNOW | 68 WINGATE ROAD HOLLISTON, MA 01746 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | $0 | $4 | 0.34% |
| DANIEL P CLARK3 Filed as: DANIEL L. CLARK | 33 LANDAU ROAD PLAINVILLE, MA 02762 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | $0 | $2 | 0.17% |
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 | 320 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 320 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 217 | $1.6M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 127 | $72K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 127 | $72K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 257 | $75K |
| Short-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 257 | $78K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 257 | $75K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE | 217 | $1.6M |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 320 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 320 | — |
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.