| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 101 HUNTINGTON AVE SUITE 401 BOSTON, MA 02199 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $20K | $12K | $31K | 4.65% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 101 HUNTINGTON AVE SUITE 401 BOSTON, MA 02199 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $3K | — | $3K | 4.39% |
| SEE ATTACHED3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $798 | $27 | $825 | 9.57% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 101 HUNTINGTON AVE SUITE 401 BOSTON, MA 02199 | VISION SERVICE PLAN | $640 | — | $640 | 8.20% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 101 HUNTINGTON AVE SUITE 401 BOSTON, MA 01608 | MONY LIFE INSURANCE COMPANY OF AMERICA | $608 | — | $608 | 11.62% |
| INDIGO INSURANCE SERVICES3 | 5TH FLOOR 446 MAIN STREET WORCESTER, MA 01608 | MONY LIFE INSURANCE COMPANY OF AMERICA | — | $366 | $366 | 6.99% |
| SEE ATTACHED3 | — | THE PAUL REVERE LIFE INSURANCE COMPANY | $142 | — | $142 | 6.56% |
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 | 144 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 118 | $678K |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 117 | $75K |
| Vision | VISION SERVICE PLAN | 73 | $8K |
| Life insurance | MONY LIFE INSURANCE COMPANY OF AMERICA | 176 | $5K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 118 | $678K |
| Other(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 176 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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.