| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FMG INSURANCE AGENCY INC3 Filed as: FMG FINANCIAL SERVICES | 228 PARK AVE WORCESTER, MA 01609 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | $53K | $3K | $55K | 2.44% |
| FMG INSURANCE AGENCY INC3 Filed as: FMG INSURANCE AGENCY | 228 PARK AVE WORCESTER, MA 01609 | DENTAL SERVICE OF MASSACHUSETTS, INC DBA DELTA DENTAL OF MA | $6K | — | $6K | 3.84% |
| HARDY, DANA P.3 | 160 GOULD ST STE 212 NEEDHAM HEIGHTS, MA 02494 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 8.79% |
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 | 207 | 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) | 207 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | 342 | $2.3M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC DBA DELTA DENTAL OF MA | 358 | $144K |
| Vision | VISION SERVICE PLAN | 120 | $13K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 132 | $61K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 132 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 358 | — |
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.