| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WEST RIDGE INSURANCE AGENCY, INC.3 | 155 FEDERAL STREET BOSTON, MA 02110 | BLUE CROSS BLUE SHIELD OF MA, INC. | $209K | $60K | $269K | 2.38% |
| WEST RIDGE INSURANCE AGENCY, INC.3 Filed as: WEST RIDGE INSURNACE AGENCY, INC. | 155 FEDERAL STREET BOSTON, MA 02110 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $5K | $20K | 3.17% |
| AGIS NETWORK INC3 Filed as: AGIS NETWORK, INC. | 2122 KRATKY ROAD ST. LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $34K | $2K | $36K | 11.38% |
| WEST RIDGE INSURANCE AGENCY, INC.3 | 155 FEDERAL STREET BOSTON, MA 02110 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $34K | $682 | $35K | 11.09% |
| WEST RIDGE INSURANCE AGENCY, INC.3 | 155 FEDERAL STREET BOSTON, MA 02110 | HUMANA | $6K | — | $6K | 9.94% |
| JULIE GERSHON4 | 11 PADDOCK STREET WIIMINGTON, MA 01887 | PRE-PAID LEGAL SERVICES, INC. | $1K | — | $1K | 9.11% |
| WEST RIDGE INSURANCE AGENCY, INC.3 | 155 FEDERAL STREET BOSTON, MA 02110 | PRE-PAID LEGAL SERVICES, INC. | $746 | — | $746 | 5.95% |
| ROSE GERSHON-SCHNEIDER4 | 554 NW 97TH AVE PLANTATION, FL 33324 | PRE-PAID LEGAL SERVICES, INC. | $187 | — | $187 | 1.49% |
| SCOTT MAIBOR4 | 2 NEPTUNE ROAD BOSTON, MA 02128 | PRE-PAID LEGAL SERVICES, INC. | $9 | — | $9 | 0.07% |
| WEST RIDGE INSURANCE AGENCY, INC.3 | 155 FEDERAL STREET BOSTON, MA 02110 | ACE AMERICAN INSURANCE COMPANY | $285 | — | $285 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MA EIN 04-1045815 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $102K |
| WEST RIDGE INSURANCE AGENCY, INC. EIN 04-2391081 BROKER | Insurance agents and brokers Service code 22 | — | $35K |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 CONTRACT ADMINISTRATOR | Participant communication; Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $21K |
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 | 1,107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MA, INC. | 902 | $11.3M |
| Vision | HUMANA | 475 | $63K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,090 | $637K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,090 | $637K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,090 | $637K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MA, INC. | 902 | $11.3M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,107 | $330K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,107 | — |
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.