| 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 | $44K | $13K | $57K | 1.70% |
| THE ROWLEY AGENCY Filed as: ROWLEY AGENCY | PO BOX 511 CONCORD, NH 03302 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | $24K | — | $24K | 0.71% |
| THE ROWLEY AGENCY3 Filed as: ROWLEY AGENCY | PO BOX 511 CONCORD, NH 03302 | BLUE CROSS BLUE SHIELD OF MA | $12K | — | $12K | 1.99% |
| THE ROWLEY AGENCY3 | PO BOX 511 CONCORD, NH 03302 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 4.28% |
| HARDY, DANA P.3 | 160 GOULD ST STE 212 NEEDHAM HEIGHTS, MA 02494 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 2.90% |
| MICHAEL HANLEY3 | 228 PARK AVE WORCESTER, MA 01609 | VISION SERVICE PLAN | $805 | — | $805 | 3.66% |
| THE ROWLEY AGENCY3 | PO BOX 511 CONCORD, NH 03302 | VISION SERVICE PLAN | $544 | — | $544 | 2.48% |
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 | 299 | 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) | 299 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | 453 | $3.9M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC DBA DELTA DENTAL OF MA | 497 | $219K |
| Vision | VISION SERVICE PLAN | 194 | $22K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 111 | $94K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 111 | $94K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 111 | $94K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 111 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 497 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.