| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOSTONIAN GROUP | UNKNOWN LOWELL, MA 01851 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $32K | $17K | $49K | 4.30% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT ASSOC., INC. | 1 BEACON STREET, 25TH FLOOR BOSTON, MA 02108 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $1K | $10K | 10.03% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 500 BOYLSTON STREET, 3RD FLOOR BOSTON, MA 02116 | VISION SERVICE PLAN | $721 | — | $721 | 5.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: THE BOSTONIAN GROUP | 500 BOYLSTON STREET, 3RD FLOOR BOSTON, MA 02116 | VISION SERVICE PLAN | $118 | — | $118 | 0.94% |
No Schedule C service providers reported on this filing.
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 | 148 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 215 | $1.1M |
| Vision | VISION SERVICE PLAN | 83 | $12K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 150 | $100K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 150 | $100K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 150 | $100K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 215 | $1.1M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 150 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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.