| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE OF NE LLC | 133 FEDERAL STREET BOSTON, MA 02110 | HARVARD PILGRIM HEALTH CARE | $16K | — | $16K | 1.97% |
| THORBAHN & ASSOCIATES3 Filed as: THORBAHN & ASSOCIATES INSURANCE AGE | 141 LONGWATER DRIVE NORWELL, MA 02061 | HARVARD PILGRIM HEALTH CARE | $24 | — | $24 | 0.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | NCB 88 P.O. BOX 1414 MINNEAPOLIS, MN 55480 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | $2K | — | $2K | 2.36% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH STREET MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 9.13% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH STREET MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 10.32% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $601 | — | $601 | 5.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH STREET MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $458 | — | $458 | 5.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP OF NEW ENGLAND | 133 FEDERAL STREET BOSTON, MA 02110 | EYEMED VISION CARE | $758 | — | $758 | 10.01% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 20.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $280 | $224 | $504 | 9.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH STREET MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $456 | — | $456 | 10.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $209 | — | $209 | 4.58% |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 133 | $814K |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | 139 | $76K |
| Vision | EYEMED VISION CARE | 92 | $8K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 117 | $12K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 116 | $30K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 116 | $9K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE | 133 | $808K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 117 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 139 | — |
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."
No prospect flags tripped on this filing.