| 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 02026 | BLUE CROSS BLUE SHIELD OF MA, INC. | $248K | $174K | $422K | 1.51% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MA, INC. | $12K | — | $12K | 0.04% |
| 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 | $80K | $27K | $107K | 13.42% |
| 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 | $100K | $24K | $124K | 18.68% |
| 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 | $49K | $18K | $67K | 13.68% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA, LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $54K | — | $54K | 11.24% |
| STRATEGIC NON-MEDICAL SOLUTION3 | ONE BEACON STREET SUITE 17100 BOSTON, MA 02108 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $54K | — | $54K | 11.24% |
| 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 | $7K | $6K | $13K | 3.34% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $14K | — | $14K | 9.15% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $1K | — | $1K | 0.85% |
| UNIQUE BENEFITS GROUP INC4 | 7 CAPOZZI CIR WOBURN, MA 01801 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $5K | — | $5K | 8.58% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA INC | 300 N BEACH STREET DAYTONA BEACH, FL 32114 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | — | $2K | 4.28% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS LLC | 155 FEDERAL STREET STE 1500 BOSTON, MA 02110 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $760 | — | $760 | 1.34% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NY INC | 45 EAST AVE ROCHESTER, NY 14604 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $91 | — | $91 | 0.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $27 | — | $27 | 0.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE | 155 FEDERAL STREET STE 1500 BOSTON, MA 02110 | ACE AMERICAN INSURANCE COMPANY | $285 | — | $285 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 04-1045815 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $121K |
| NIVATI, INC. EIN 27-2284248 CONTRACT ADMINISTRATOR | Direct payment from the plan; Participant communication; Claims processing; Contract Administrator Service code 12 | — | $109K |
| BROWN & BROWN OF MA, LLC EIN 27-4732361 BROKER | Insurance agents and brokers Service code 22 | — | $59K |
| EVERNORTH BEHAVIORAL HEALTH, INC. EIN 41-1648670 CONTRACT ADMINISTRATOR | Participant communication; Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $34K |
| BROWN & BROWN INSURANCE SERVICES, I EIN 27-4732361 BROKER | Insurance agents and brokers Service code 22 | — | $6K |
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 | 1,745 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,767 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MA, INC. | 1,628 | $28.0M |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,259 | $154K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,729 | $664K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,745 | $607K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,745 | $797K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MA, INC. | 1,628 | $28.0M |
| Other(6 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,914 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,914 | — |
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.