| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS. AGY, INC. | 1 GRIFFIN BROOK DRIVE METHUEN, MA 01844 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $158K | $53K | $211K | 2.67% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 669 RIVER DRIVE CENTRE II SUITE 305 ELMWOOD PARK, NJ 07407 | HARTFORD LIFE AND ACCIDENT | $56K | $24K | $81K | 22.35% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SERVICES, INC | 901 MARQUETTE AVENUE, SUITE 1800 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $13 | $0 | $13 | 0.00% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGNCY INC. | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | HARTFORD LIFE AND ACCIDENT | $7 | $0 | $7 | 0.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SERVICES, INC. | 100 RIALTO PLACE, SUITE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | $0 | $4 | $4 | 0.00% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS. AGY, INC. | 1 GRIFFIN BROOK DRIVE METHUEN, MA 01844 | VISION SERVICE PLAN | $2K | — | $2K | 3.58% |
| UNIQUE BENEFITS GROUP INC4 Filed as: UNIQUE BENEFITS GROUP, INC. | 7 CAPOZZI CIRCLE WOBURN, MA 01801 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $208 | — | $208 | 8.20% |
| ASSUREDPARTNERS4 Filed as: JENNIFER A. BORISLOW INSURANCE A | 1 GRIFFIN BROOK DRIVE METHUEN, MA 01844 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $36 | — | $36 | 1.42% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL NEW ENGLAND | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $32 | $0 | $32 | 1.26% |
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 | 714 | 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) | 715 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,398 | $7.9M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,398 | $7.9M |
| Vision | VISION SERVICE PLAN | 382 | $58K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 715 | $360K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 715 | $360K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 715 | $360K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,398 | $7.9M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 715 | $381K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,398 | — |
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.