| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $3K | — | $3K | 4.37% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | EYEMED VISION CARE | $996 | — | $996 | 9.11% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $716 | $258 | $974 | 18.73% |
| NEESENROLL3 | 65 BURBANK RD. SUTTON, MA 01590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $464 | $464 | 8.92% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $724 | — | $724 | 25.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH PLANS, INC. EIN 04-2734278 THIRD PARTY ADMINISTRATO | Claims processing; Contract Administrator; Other services Service code 12 | — | $104K |
| HILB GROUP OF NEW ENGLAND BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | $81K |
| LIVINITI THIRD PARTY ADMINISTRATO | Contract Administrator; Claims processing Service code 12 | 411 BIENVILLE ST. NATCHITOCHES, LA 71457 | $16K |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 171 | $80K |
| Vision | EYEMED VISION CARE | 144 | $11K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 109 | $8K |
| Stop-loss / reinsurancereinsurance | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | 145 | $304K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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."
No prospect flags tripped on this filing.