| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE, 13TH FLOOR BOSTON, MA 02210 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $31K | $9K | $40K | 2.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGON AVENUE BOSTON, MA 02116 | DELTA DENTAL OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $3K | $84 | $3K | 2.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE BOSTON, MA 02116 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 6.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 3.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2345 GRAND BOULEVARD, SUITE 400 KANSAS CITY, MO 64108 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $1K | $1K | 1.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | VISION SERVICE PLAN | $848 | — | $848 | 6.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | GERBER LIFE INSURANCE COMPANY | $327 | — | $327 | 15.01% |
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 | 110 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 179 | $1.4M |
| Dental | DELTA DENTAL OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 212 | $132K |
| Vision | VISION SERVICE PLAN | 103 | $13K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 110 | $75K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 110 | $75K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 110 | $75K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 179 | $1.4M |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 110 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 212 | — |
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.