| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 12 GILL STREET, SUITE 5500 WOBURN, MA 01888 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | $52K | — | $52K | 1.57% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | — | $21K | $21K | 0.64% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF MASSACHUSETTS | $8K | — | $8K | 2.85% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 12 GILL STREET, SUITE 5500 WOBURN, MA 01888 | TUFTS INSURANCE COMPANY | $2K | — | $2K | 1.41% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 3716 NORFOLK, VA 23514 | TUFTS INSURANCE COMPANY | — | $1K | $1K | 0.73% |
| COSTELLO BENEFITS GROUP3 Filed as: COSTELLO BENEFITS GROUP INSURANCE | 800 WEST CUMMINGS PARK, SUITE 6900 WOBURN, MA 01801 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $2K | $17K | 14.19% |
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 | 304 | 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) | 304 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | 544 | $3.5M |
| Dental | DELTA DENTAL OF MASSACHUSETTS | 522 | $275K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 304 | $122K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 304 | $122K |
| Prescription drug(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | 544 | $3.5M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 304 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 544 | — |
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.