| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE SUITE 1710 BOSTON, MA 02109 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $145K | $55K | $200K | 2.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 470 ATLANTIC AVENUE SUITE 1710 BOSTON, MA 02109 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | — | $205 | $205 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE SUITE 1710 BOSTON, MA 02109 | HARTFORD LIFE AND ACCIDENT | $26K | — | $26K | 3.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 0.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC STREET BOSTON, MA 022102208 | VISION SERVICE PLAN | $2K | — | $2K | 3.15% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | HARTFORD LIFE AND ACCIDENT | $771 | — | $771 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| STATE STREET BANK AND TRUST COMPANY EIN 04-1867445 TRUSTEE/CUSTODIAN | Trustee (directed) Service code 25 | — | $18K |
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 | 671 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 130 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 801 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,689 | $9.8M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,689 | $9.8M |
| Vision | VISION SERVICE PLAN | 586 | $67K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 899 | $721K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 899 | $721K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,689 | $9.8M |
| Other(2 contracts) | HARTFORD LIFE AND ACCIDENT | 899 | $726K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,689 | — |
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.