| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS LLC | 333 ELM STREET SUITE 300 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $58K | — | $58K | 1.56% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS LLC | 333 ELM STREET SUITE 300 DEDHAM, MA 02026 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $24K | $4K | $28K | 12.93% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | 333 ELM STREET SUITE 300 DEDHAM, MA 02026 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 11.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MASS EIN 04-1045815 TPA FOR DENTAL | Claims processing; Contract Administrator Service code 12 | — | $46K |
| BROWN & BROWN OF MASSACHUSETTS BROKER OF RECORD | Insurance brokerage commissions and fees Service code 53 | 333 ELM STREET SUITE 300 DEDHAM, MA 02026 | $12K |
| UNUM LIFE INSURANCE COMPANY EIN 01-0278678 ASO | Contract Administrator; Claims processing Service code 12 | — | $9K |
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 | 488 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 494 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 691 | $3.7M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 355 | $15K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 488 | $216K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 488 | $216K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 488 | $216K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 691 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.