| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GAUDREAU GROUP INS AGENCY3 Filed as: GAUDREAU GROUP INS, AGENCY | 2377 BOSTON ROAD WILBRAHAM, MA 01095 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $19K | $8K | $27K | 4.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NEW ENGLAND DENTAL ADMIN. LLC EIN 04-3351309 DENTAL CLAIMS PROCESSING | Claims processing Service code 12 | P O BOX 2006 CONCORD, NH 03302 | $9K |
| THE GAUDREAU GROUP, INC EIN 04-2224848 BROKER | Insurance agents and brokers Service code 22 | 2377 BOSTON ROAD WILBRAHAM, MA 01095 | $3K |
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 | 137 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 137 | $649K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 137 | $649K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.