| 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. | $105K | — | $105K | 0.98% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 60673 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $49K | $329 | $49K | 0.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE SUITE 1710 BOSTON, MA 02109 | HARTFORD LIFE AND ACCIDENT | $15K | — | $15K | 2.05% |
| AON CONSULTING INC3 Filed as: AON CONSULTING OF NEW JERSEY | 29840 NETWORK PLACE CHICAGO, IL 606731299 | HARTFORD LIFE AND ACCIDENT | $11K | — | $11K | 1.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | HARTFORD LIFE AND ACCIDENT | — | $11K | $11K | 1.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC STREET BOSTON, MA 022102208 | VISION SERVICE PLAN | $1K | — | $1K | 1.72% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 606731298 | VISION SERVICE PLAN | $959 | — | $959 | 1.43% |
| 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 | — | $28K |
| U.S. BANK EIN 31-0841368 TRUSTEE/CUSTODIAN | Trustee (directed) Service code 25 | — | $859 |
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 | 684 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 109 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 793 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,767 | $10.7M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,767 | $10.7M |
| Vision | VISION SERVICE PLAN | 591 | $67K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 909 | $729K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 909 | $729K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,767 | $10.7M |
| Other(2 contracts) | HARTFORD LIFE AND ACCIDENT | 909 | $735K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,767 | — |
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.