| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $79K | — | $79K | 3.14% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $17K | — | $17K | 0.66% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 100 FRONT STREET 20TH FLOOR WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $12K | $12K | 24.01% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $8K | — | $8K | 14.96% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA INC. | 100 RIALTO PLACE STE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 2.03% |
| RSC INSURANCE BROKERAGE INC3 | 800 W CUMMINGS PARK STE 4000 WOBURN, MA 01801 | HARTFORD LIFE AND ACCIDENT | $10 | — | $10 | 0.02% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 100 FRONT STREET 20TH FLOOR WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $13K | $13K | 25.19% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 80 SOUTH 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA INC. | 100 RIALTO PLACE STE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 2.58% |
| RSC INSURANCE BROKERAGE INC3 | 800 W CUMMINGS PARK STE 4000 WOBURN, MA 01801 | HARTFORD LIFE AND ACCIDENT | $8 | — | $8 | 0.02% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 100 FRONT STREET 20TH FLOOR WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $15K | $15K | 29.35% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA INC. | 100 RIALTO PLACE STE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 2.07% |
| RSC INSURANCE BROKERAGE INC3 | 800 W CUMMINGS PARK STE 4000 WOBURN, MA 01801 | HARTFORD LIFE AND ACCIDENT | $13 | — | $13 | 0.03% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 220 S RIDGEWOOD AVE DAYTONA BEACH, FL 321144318 | HUMANA INSURANCE COMPANY | $1K | — | $1K | 8.35% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 100 FRONT STREET 20TH FLOOR WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $3K | $3K | 25.35% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 10.00% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 100 FRONT STREET 20TH FLOOR WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $118 | $118 | 29.35% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $40 | — | $40 | 9.95% |
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 | 198 | 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) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 325 | $2.5M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 325 | $2.5M |
| Vision | HUMANA INSURANCE COMPANY | 114 | $15K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 198 | $51K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 205 | $50K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 223 | $52K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 325 | $2.5M |
| Other(5 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 325 | $2.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 325 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.