| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02086 | BLUE CROSS BLUE SHIELD OF MA, INC. | $312K | $156K | $468K | 2.13% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA, LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $55K | $26K | $80K | 14.67% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA, LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $69K | $21K | $91K | 19.65% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA | 333 ELM STREET, SUITE 300 DEDHAM, MA 02026 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $50K | — | $50K | 10.91% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 12647 ALCOSTA BLVD. SUITE 330 SAN RAMON, CA 94583 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $50K | — | $50K | 10.91% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA, LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $34K | $18K | $52K | 15.32% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 2.10% |
| UNIQUE BENEFITS GROUP INC4 Filed as: UNIQUE BENEFITS GROUP | 7 CAPOZZI CIRCLE WOBURN, MA 01801 | PRE-PAID LEGAL SERVICES, INC. | $3K | — | $3K | 9.31% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | PRE-PAID LEGAL SERVICES, INC. | $2K | — | $2K | 5.20% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA, INC. | 220 S RIDGEWOOD AVE SUITE 210 DAYTONA, FL 32114 | PRE-PAID LEGAL SERVICES, INC. | $660 | — | $660 | 2.18% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | ACE AMERICAN INSURANCE COMPANY | $285 | $23 | $308 | 16.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 04-1045815 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $142K |
| NIVATI, INC. EIN 27-2284248 CONTRACT AMINISTRATOR | Contract Administrator; Participant communication; Claims processing; Direct payment from the plan Service code 12 | — | $87K |
| HARRIS, ROTHENBERG INTERNATIONAL EIN 27-1649291 CONTRACT ADMINISTRATOR | Claims processing; Direct payment from the plan; Participant communication; Contract Administrator Service code 12 | — | $72K |
| BROWN & BROWN OF MA, LLC EIN 27-4732361 BROKER | Insurance agents and brokers Service code 22 | — | $53K |
| EVERNORTH BEHAVIORAL HEALTH, INC. EIN 41-1648670 CONTRACT ADMINISTRATOR | Direct payment from the plan; Participant communication; Claims processing; Contract Administrator Service code 12 | — | $24K |
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 | 1,415 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,430 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MA, INC. | 1,346 | $22.0M |
| Vision | HUMANA INSURANCE COMPANY | 1,017 | $138K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,405 | $461K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,413 | $439K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,413 | $548K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MA, INC. | 1,346 | $22.0M |
| Other(6 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,621 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,621 | — |
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.