| 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 MASSACHUSETTS, INC. | $75K | $35K | $110K | 2.21% |
| AMR BENEFITS MANAGEMENT, LLC3 | 210 HUMPHREY STREET, SUITE 107 MARBLEHEAD, MA 01945 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $6K | — | $6K | 0.12% |
| HAYS COMPANIES, INC.3 | 80 S 8TH ST., SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $20K | — | $20K | 5.81% |
| AMR BENEFITS MANAGEMENT, LLC3 | 210 HUMPHREY STREET, SUITE 107 MARBLEHEAD, MA 01945 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 0.94% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 133 FEDERAL STREET BOSTON, MA 02110 | EYEMED VISON CARE B/O FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | — | $5K | 10.52% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MA CLAIMS PROCESSOR | Claims processing Service code 12 | 101 HUNTINGTON AVE, SUITE 1300 BOSTON, MA 02199 | $52K |
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 | 438 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 438 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 914 | $5.0M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 914 | $5.0M |
| Vision | EYEMED VISON CARE B/O FIDELITY SECURITY LIFE INSURANCE COMPANY | 778 | $52K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 349 | $347K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 349 | $347K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 349 | $347K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 914 | $5.0M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 349 | $347K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.