| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHANDOR INSURANCE AGENCY LLC | 177 MILK STREET, STE 310 BOSTON, MA 02109 | HARVARD PILGRIM HEALTH CARE | $21K | — | $21K | 1.25% |
| BOSTON COMMONWEALTH ADVANTAGE LLC | 62 ACCORD PARK DRIVE, STE 1 NORWELL, MA 02061 | HARVARD PILGRIM HEALTH CARE | $7K | — | $7K | 0.42% |
| CHANDOR INSURANCE AGENCY LLC | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $924 | $3K | 9.53% |
| BOSTON COMMONWEALTH ADVANTAGE LLC | 62 ACCORD PARK DRIVE, STE 1 NORWELL, MA 02061 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $433 | — | $433 | 1.36% |
| CHANDOR INSURANCE AGENCY LLC | 177 MILK STREET, STE 310 BOSTON, MA 02109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $282 | $1K | 14.29% |
| BOSTON COMMONWEALTH ADVANTAGE LLC | 62 ACCORD PARK DRIVE, STE 1 NORWELL, MA 02061 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $348 | — | $348 | 3.73% |
| CHANDOR INSURANCE AGENCY LLC | 177 MILK STREET, STE 310 BOSTON, MA 02109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $324 | $108 | $432 | 12.01% |
| BOSTON COMMONWEALTH ADVANTAGE LLC | 62 ACCORD PARK DRIVE, STE 1 NORWELL, MA 02061 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $108 | — | $108 | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SEIU LOCAL 888 EIN 05-0578962 COMMON MEMBERS | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 25 BRAINTREE HILL OFFICE PARK BRAINTREE, MA 02184 | $78K |
| BOSTON BENEFIT PARTNERS EIN 04-3422351 NONE | Insurance agents and brokers Service code 22 | 177 MILK STREET BOSTON, MA 02109 | $29K |
| PARAGON CORPORATION EIN 04-3358691 NONE | Consulting (general) Service code 16 | 1 DEVONSHIRE PLACE BOSTON, MA 02109 | $18K |
| O'BRIEN, RILEY & RYAN PC EIN 04-3176941 NONE | Accounting (including auditing) Service code 10 | 30 BRAINTREE HILL OFFICE PARK BRAINTREE, MA 02184 | $14K |
| DELTA DENTAL OF MASSACHUSETTS EIN 04-6143185 NONE | Contract Administrator Service code 13 | 465 MEDFORD STREET BOSTON, MA 02129 | $11K |
| F L PUTNAM EIN 01-0403396 INVESTMENT ADVISOR | Investment advisory (plan) Service code 27 | 20 WILLIAMS STREET WELLESLEY, MA 02481 | $9K |
| BOSTON BUILDING SERVICE EMPLOYEES EIN 04-6119050 COMMON MEMBERS | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 26 WEST STREET BOSTON, MA 02110 | $8K |
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 | 284 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 187 | $1.7M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 93 | $4K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 93 | $32K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 93 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.