| 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 | $62K | $12K | $73K | 2.55% |
| 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 | $7K | — | $7K | 3.44% |
| HARDY, DANA P.3 | 160 GOULD ST STE 212 NEEDHAM HEIGHTS, MA 02494 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 2.80% |
| MICHAEL HANLEY3 | 228 PARK AVE WORCESTER, MA 016092248 | VISION SERVICE PLAN | $1K | — | $1K | 6.37% |
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 | 285 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | 394 | $2.9M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC DBA DELTA DENTAL OF MA | 458 | $191K |
| Vision | VISION SERVICE PLAN | 125 | $18K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 122 | $172K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 122 | $172K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 122 | $172K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 122 | $172K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 458 | — |
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.