| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 | 135 BEAVER ST., STE. 404 WALTHAM, MA 02452 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $53K | — | $53K | 2.22% |
| GROUP BROKERAGE INS. AGENCY LLC3 | 69 CARLETON ROAD BELMONT, MA 02478 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $18K | $11K | $29K | 1.22% |
| HILB GROUP OF NEW ENGLAND3 | 135 BEAVER ST., STE. 404 WALTHAM, MA 02452 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $5K | — | $5K | 3.63% |
| GROUP BROKERAGE INS. AGENCY LLC3 | 129 MOUNT AUBURN STREET CAMBRIDGE, MA 02138 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $2K | — | $2K | 1.37% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 135 BEAVER ST., STE. 404 WALTHAM, MA 02452 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $4K | $10K | 13.12% |
| GROUP BROKERAGE INS. AGENCY LLC3 | 135 BEAVER ST., STE. 404 WALTHAM, MA 02452 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 2.19% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 2000 CHAPEL VIEW BLVD SUITE 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $769 | — | $769 | 1.02% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND | 135 BEAVER ST., STE. 404 WALTHAM, MA 02452 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $4K | 13.13% |
| GROUP BROKERAGE INSURANCE AGENCY3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 3.22% |
| JOHN FRANK SIRACUSA3 | 69 CARLETON ROAD BELMONT, MA 02478 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.50% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 135 BEAVER ST., STE. 404 WALTHAM, MA 02452 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $3K | $4K | 22.79% |
| GROUP BROKERAGE INS. AGENCY LLC3 | 69 CARLETON ROAD BELMONT, MA 02478 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $199 | — | $199 | 1.10% |
| JOHN FRANK SIRACUSA3 | 69 CARLETON ROAD BELMONT, MA 02478 | STANDARD INSURANCE COMPANY | $816 | — | $816 | 6.50% |
| JOHN FRANK SIRACUSA3 | 69 CARLETON ROAD BELMONT, MA 02478 | EYEMED VISION CARE OBO FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 9.99% |
| JOHN FRANK SIRACUSA3 | 69 CARLETON ROAD BELMONT, MA 02478 | STANDARD INSURANCE COMPANY | $603 | — | $603 | 6.50% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 135 BEAVER ST., STE. 404 WALTHAM, MA 02452 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $782 | $522 | $1K | 14.61% |
| GROUP BROKERAGE INS. AGENCY LLC3 | 69 CARLETON ROAD BELMONT, MA 02452 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $111 | — | $111 | 1.24% |
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 | 199 | 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) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 363 | $2.4M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 290 | $130K |
| Vision | EYEMED VISION CARE OBO FIDELITY SECURITY LIFE INSURANCE COMPANY | 165 | $11K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 207 | $27K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 206 | $100K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 110 | $46K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 207 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 363 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.