| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC0 Filed as: MARSH INS & INVESTMENT CORP | 4 CHASE METROTECH CTR 7E PO BOX 26945 BROOKLYN, NY 112450003 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $37 | $13K | 3.35% |
| MARSH & MCLENNAN AGENCY LLC0 Filed as: MARSH INS & INVESTMENT CORP | 4 CHASE METROTECH CTR FL 7E PO BOX 26945 BROOKLYN, NY 112450003 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.71% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC. | ONE GATEWAY CTR STE. 551 NEWTON, MA 02458 | FEDERAL INSURANCE COMPANY | $872K | — | $872K | 1500.05% |
| STEPHEN SNOW3 | 153 CORDAVILLE ROAD SOUTHBOROUGH, MA 01772 | AFLAC | $2K | $9 | $2K | 8.71% |
| FRED SNOW3 | 27 JERROLD ST HOLLISTON, MA 01746 | AFLAC | $2K | $36 | $2K | 5.90% |
| THOMAS E ACKERMAN II3 Filed as: THOMAS ACKERMAN II | 30 WHEELER RD RUTLAND, MA 01543 | AFLAC | $685 | $9 | $694 | 2.54% |
| DINA L LONGTIN3 Filed as: DINA IBACH | 233 E 13TH ST APT 2302 CHICAGO, IL 60605 | AFLAC | $420 | $0 | $420 | 1.54% |
| DANIEL P CLARK3 Filed as: DANIEL CLARK | 33 LANDAU RD PLAINVILLE, MA 02762 | AFLAC | $339 | $10 | $349 | 1.28% |
| ANDREW CHAPMAN3 | 66 SQUIRE DRIVE NASHUA, NH 03063 | AFLAC | $79 | $0 | $79 | 0.29% |
| ROCKWELL & ASSOCIATES3 | 303 W ERIE ST SUITE 400 CHICAGO, IL 60654 | AFLAC | $72 | $0 | $72 | 0.26% |
| AMY BERG3 | 46 JENNINGS RD HOLLISTON, MA 01746 | AFLAC | $66 | $0 | $66 | 0.24% |
| NASCA & ASSOCIATES3 Filed as: NASCA AND ASSOCIATES | 303 W ERIE ST STE 400 CHICAGO, IL 60654 | AFLAC | $61 | $0 | $61 | 0.22% |
| MAUREEN E SNOW3 Filed as: MAUREEN SNOW | 68 WINGATE RD HOLLISTON, MA 01746 | AFLAC | $55 | $0 | $55 | 0.20% |
| THE SEGAL COMPANY3 Filed as: LAURA SEGAL | 360 W ILLINOIS ST APT 9A CHICAGO, IL 60654 | AFLAC | $53 | $0 | $53 | 0.19% |
| TREVOR FENNELL3 | 1835 QUEENS BLVD STE 1403 FOREST HILLS, NY 11375 | AFLAC | $43 | $0 | $43 | 0.16% |
| K & J NELSON INC3 Filed as: K AND J NELSON INC | 8512 WESTERLAND DRIVE LAND O LAKES, FL 34637 | AFLAC | $42 | $0 | $42 | 0.15% |
| JEFFREY NELSON3 | 8512 WESTERLAND DRIVE LAND O LAKES, FL 34637 | AFLAC | $38 | $0 | $38 | 0.14% |
| SHAWN ADORNO3 | 27393 DETROIT RD APT C13 WESTLAKE, OH 44145 | AFLAC | $26 | $0 | $26 | 0.10% |
| MARIA MULLIGAN3 | 19420 N 59TH AVE STE C521 GLENDALE, AZ 85308 | AFLAC | $20 | $0 | $20 | 0.07% |
| NICOLE E BRINDLE3 Filed as: NICOLE BRINDLE | 3933 E ROSEMONTE PHOENIX, AZ 85050 | AFLAC | $19 | $0 | $19 | 0.07% |
| JILL SAUNDERS3 | 7 UNION ST NORTH EASTON, MA 02356 | AFLAC | $12 | $5 | $17 | 0.06% |
| CRP BENEFIT SERVICES INC3 | 6000 LOMBARDO CENTER STE 145 SEVEN HILLS, OH 44131 | AFLAC | $15 | $0 | $15 | 0.05% |
| BRANDI L KEBALKA3 Filed as: BRANDI KELBALKA | 32 HOBART ST BRIGHTON, MA 02135 | AFLAC | $15 | $0 | $15 | 0.05% |
| LISBETH A MOG3 Filed as: LISBETH MOG | 67 FISKE ST HOLLISTON, MA 01746 | AFLAC | $14 | $0 | $14 | 0.05% |
| MULLIGAN BENEFITS LLC3 | 19420 N 59TH AVE STE C521 GLENDALE, AZ 85308 | AFLAC | $10 | $0 | $10 | 0.04% |
| SUSAN BRIMHALL3 | 155 CYPRESS LN SUITE 525 OLDSMAR, FL 34677 | AFLAC | $8 | $0 | $8 | 0.03% |
| DONALD GREEN0 | 1611 W PLACITE GARBO GREEN VALLEY, AZ 85622 | AFLAC | $5 | — | $5 | 0.02% |
| MAKOWSKI INS AGCY INC3 Filed as: MAKOWSKI INS AGENCY INC | 9404 WOODCHIP LN BROADVIEW HEIGHTS, OH 44147 | AFLAC | $3 | $0 | $3 | 0.01% |
| MERCEDES NOBLE REYES3 | 2041 WATERBURY RD LAKEWOOD, OH 44107 | AFLAC | $3 | $0 | $3 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 CLAIMS ADMINISTRATION | Contract Administrator; Non-monetary compensation; Other services; Direct payment from the plan; Claims processing; Named fiduciary; Participant communication; Float revenue Service code 12 | — | $220K |
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 | 1,603 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,626 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 2,504 | $20.3M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MA | 4,065 | $76K |
| Vision | HM LIFE INSURANCE COMPANY | 1,134 | $5.5M |
| Life insurance(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,597 | $1.1M |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,549 | $505K |
| Other(5 contracts, 5 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,603 | $818K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,065 | — |
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."
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.