| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMR BENEFITS MANAGEMENT, LLC3 | 210 HUMPHREY STREET, SUITE 107 MARBLEHEAD, MA 01945 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $42K | $893 | $43K | 1.90% |
| ROBERT H PETROCELLI3 Filed as: ROBERT PETROCELLI | 1300 CONCORD TERRACE, 5TH FLOOR SUNRISE, FL 33323 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $5K | — | $5K | 0.24% |
| ROBERT H PETROCELLI3 Filed as: ROBERT PETROCELLI | 1300 CONCORD TERRACE, 5TH FL SUNRISE, FL 33323 | NEW YORK LIFE GROUP BENEFIT SOLUTIONS | $11K | — | $11K | 9.19% |
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 | 160 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 273 | $2.2M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 273 | $2.2M |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 273 | $2.2M |
| Life insurance | NEW YORK LIFE GROUP BENEFIT SOLUTIONS | 160 | $122K |
| Short-term disability | NEW YORK LIFE GROUP BENEFIT SOLUTIONS | 160 | $122K |
| Long-term disability | NEW YORK LIFE GROUP BENEFIT SOLUTIONS | 160 | $122K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 273 | $2.2M |
| Other | NEW YORK LIFE GROUP BENEFIT SOLUTIONS | 160 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 273 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.