| 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 | $33K | — | $33K | 2.67% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS LLC | 980 WASHINGTON ST SUITE 325 DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE | $18K | — | $18K | 1.42% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | $3K | — | $3K | 3.39% |
| 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 | $46 | — | $46 | 0.05% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $388 | $3K | 10.22% |
| 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: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $262 | $2K | 9.95% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $884 | — | $884 | 5.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP OF NEW ENGLAND | 133 FEDERAL STREET BOSTON, MA 02110 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 9.15% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $200 | $2K | 16.54% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $649 | — | $649 | 5.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $123 | $2K | 21.28% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $482 | $385 | $867 | 9.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $474 | $93 | $567 | 11.97% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $237 | — | $237 | 5.00% |
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 | 181 | 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) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 162 | $1.2M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | 161 | $92K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 116 | $13K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 181 | $18K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 179 | $29K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 179 | $13K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE | 162 | $1.2M |
| Other(3 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 181 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.