| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SAPERS & WALLACK3 Filed as: SAPERS & WALLACK INSURANCE | 275 WASHINGTON STREET NEWTON, MA 02458 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG, INC. | $30K | $0 | $30K | 2.52% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 2000 CHAPEL VIEW BOULEVARD SUITE 240 CRANSTON, RI 02920 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG, INC. | $0 | $17K | $17K | 1.43% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04402 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG, INC. | $967 | $0 | $967 | 0.08% |
| SAPERS & WALLACK3 Filed as: SAPERS & WALLACK INSURANCE | 275 WASHINGTON STREET NEWTON, MA 02458 | TUFTS INSURANCE COMPANY | $2K | $0 | $2K | 2.35% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 2000 CHAPEL VIEW BOULEVARD SUITE 240 CRANSTON, RI 02920 | TUFTS INSURANCE COMPANY | $0 | $662 | $662 | 1.01% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04402 | TUFTS INSURANCE COMPANY | $55 | $0 | $55 | 0.08% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 2000 CHAPEL VIEW BOULEVARD SUITE 240 CRANSTON, RI 02920 | DELTA DENTAL OF MASSACHUSETTS | $3K | $0 | $3K | 4.09% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04402 | DELTA DENTAL OF MASSACHUSETTS | $238 | $0 | $238 | 0.38% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 475 SCHOOL STREET, SUITE 5 MARSHFIELD, MA 02050 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 5.02% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 28 PARK AVENUE WORCESTER, MA 01605 | STANDARD INSURANCE COMPANY | $892 | $0 | $892 | 3.27% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 469 AUGUSTA, ME 04332 | STANDARD INSURANCE COMPANY | $49 | $0 | $49 | 0.18% |
| SAPERS & WALLACK3 Filed as: SAPERS & WALLACK INSURANCE | 275 WASHINGTON STREET, SUITE 110 NEWTON, MA 02458 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $403 | $0 | $403 | 3.72% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 2000 CHAPEL VIEW BOULEVARD SUITE 240 CRANSTON, MA 02920 | RELIANCE STANDARD LIFE INSURANCE | $1K | $188 | $1K | 16.10% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04402 | RELIANCE STANDARD LIFE INSURANCE | $102 | $0 | $102 | 1.29% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 931 JEFFERSON BOULEVARD, SUITE 3001 WARWICK, RI 02886 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $419 | $0 | $419 | 10.52% |
| SAPERS & WALLACK3 Filed as: SAPERS & WALLACK INSURANCE | 275 WASHINGTON STREET, SUITE 110 NEWTON, MA 02458 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $44 | $0 | $44 | 1.50% |
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 | 104 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG, INC. | 174 | $1.3M |
| Dental | DELTA DENTAL OF MASSACHUSETTS | 146 | $63K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 59 | $4K |
| Life insurance | STANDARD INSURANCE COMPANY | 81 | $27K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 22 | $11K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE | 16 | $8K |
| Prescription drug(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG, INC. | 174 | $1.3M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 81 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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.