| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAMBRIDGE LIFE BROKERAGE LLC3 | 875 AVENUE OF THE AMERICAS 350 FIFTH AVENUE, SUITE 801 NEW YORK, NY 10001 | SUN LIFE ASSURANCE COMPANY OF CANADA | $22K | — | $22K | 9.75% |
| EMERSON REID LLC3 | 1787 SENTRY PARKWAY SUITE 320 BLUE BELL, PA 19422 | SUN LIFE ASSURANCE COMPANY OF CANADA | $10K | $8K | $19K | 8.28% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TX HWY S #2-135 AUSTIN, TX 78746 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $1K | $1K | 0.46% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SYSTEMS INC. | 400 WASHINGTON ST SUITE 400 BRAINTREE, MA 02184 | SUN LIFE ASSURANCE COMPANY OF CANADA | $980 | — | $980 | 0.43% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLIED BENEFIT SYSTEMS LLC EIN 36-3086057 TPA | Contract Administrator; Direct payment from the plan; Other services; Claims processing Service code 12 | 200 W ADAMS ST SUITE 500 CHICAGO, IL 60606 | $44K |
| CAMBRIDGE LIFE BROKERAGE LLC EIN 45-2642901 BROKER | Direct payment from the plan; Other services; Claims processing; Contract Administrator Service code 12 | 875 AVENUE OF THE AMERICAS SUITE 801 NEW YORK, NY 10001 | $38K |
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 | 114 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $225K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $225K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $225K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $225K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $225K |
| Stop-loss / reinsurancereinsurance | SWISS RE CORPORATE SOLUTIONS AMER INSURANCE CORP | 75 | $337K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $225K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.