| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 | — | HARVARD PILGRIM HEALTH CARE | $24K | $0 | $24K | 2.62% |
| BROKER NOT PROVIDED3 Filed as: NO BROKER NAME LISTED | — | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $4K | $0 | $4K | 4.39% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 10.71% |
| EMERSON REID LLC3 | 1787 SENTRY PWY W VEVA 16 SUITE 320 BLUE BELL, PA 19422 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $5K | $5K | 9.11% |
| KLINGAMAN & ASSOCIATES, INC.3 Filed as: KLINGAMAN & ASSOCIATES INC | 131 COAL KILN ROAD PRINCETON, MA 01541 | AFLAC | $2K | $457 | $2K | 9.14% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | AFLAC | $2K | $0 | $2K | 6.96% |
| DAVID S HALLETT3 | 8 BROOKS STREET WINCHESTER, MA 01890 | AFLAC | $448 | $76 | $524 | 2.20% |
| RYAN BENEFITS INC3 Filed as: RYAN TAVARES | 10 WILLOW STREET DERRY, NH 03038 | AFLAC | $394 | $0 | $394 | 1.65% |
| DONNA ROSE BURRITT3 | 207 MAIN STREET UNIT B CHERRY VALLEY, MA 01611 | AFLAC | $84 | $0 | $84 | 0.35% |
| THOMAS E ACKERMAN II3 | 30 WHEELER ROAD RUTHLAND, MA 01543 | AFLAC | $49 | $0 | $49 | 0.21% |
| DONNA ROSE BURRITT3 | 101 WATER STREET WORCESTER, MA 01604 | AFLAC | $15 | $0 | $15 | 0.06% |
| DANIEL P CLARK3 | 33 LANDAU ROAD PLAINVILLE, MA 02762 | AFLAC | $14 | $0 | $14 | 0.06% |
| MAUREEN E SNOW3 | 68 WINGATE ROAD HOLLISTON, MA 01746 | AFLAC | $5 | $0 | $5 | 0.02% |
| NATHAN A HUMMER3 | 5 WEBBER ROAD WESTFORD, MA 01886 | AFLAC | $3 | $0 | $3 | 0.01% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 11.59% |
| EMERSON REID LLC3 | 1787 SENTRY PWY W VEVA 16 SUITE 320 BLUE BELL, PA 19422 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 9.18% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET BOSTON, MA 02110 | EYEMED | $644 | $0 | $644 | 8.91% |
| EMERSON REID LLC3 Filed as: EMERSON REID & CO | 350 FIFTH AVENUE SUITE 3700 NEW YORK, NY 10118 | EYEMED | $322 | $0 | $322 | 4.45% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $841 | $0 | $841 | 15.00% |
| EMERSON REID LLC3 | 1787 SENTRY PWY W VEVA 16 SUITE 320 BLUE BELL, PA 19422 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $479 | $479 | 8.54% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $126 | $0 | $126 | 15.05% |
| EMERSON REID LLC3 | 1787 SENTRY PWY W VEVA 16 SUITE 320 BLUE BELL, PA 19422 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $65 | $65 | 7.77% |
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 | 127 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 211 | $903K |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 196 | $84K |
| Vision | EYEMED | 151 | $7K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 118 | $11K |
| Short-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 118 | $74K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 118 | $50K |
| Other(4 contracts, 2 carriers) | AFLAC | 118 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 211 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.