| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 300 N BEACH STREET DAYTONA, FL 32114 | HARVARD PILGRIM HEALTH CARE | $25K | $14K | $38K | 2.81% |
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE OF NE LLC | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | HARVARD PILGRIM HEALTH CARE | $8K | — | $8K | 0.59% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | $3K | — | $3K | 2.82% |
| 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 | $905 | — | $905 | 0.94% |
| INDIGO INSURANCE SERVICES3 | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 5.56% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $951 | — | $951 | 2.81% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 7.51% |
| INDIGO INSURANCE SERVICES3 | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 5.56% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $923 | — | $923 | 4.24% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP OF NEW ENGLAND | 133 FEDERAL STREET 3RD FLOOR BOSTON, MA 02110 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 7.92% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 11.37% |
| INDIGO INSURANCE SERVICES3 | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $744 | $744 | 5.57% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $647 | — | $647 | 4.84% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 15.16% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $545 | — | $545 | 6.32% |
| INDIGO INSURANCE SERVICES3 | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $476 | $476 | 5.52% |
| BROWN AND BROWN OF FLORIDA, INC. Filed as: BROWN & BROWN | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $922 | — | $922 | 11.44% |
| INDIGO INSURANCE SERVICES3 | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $445 | $445 | 5.52% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $377 | — | $377 | 4.68% |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 202 | $1.4M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | 188 | $96K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 106 | $15K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 160 | $22K |
| Short-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 160 | $34K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 160 | $13K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE | 202 | $1.4M |
| Other(3 contracts) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 160 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 202 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.