| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DESIGNED BENEFITS INSURANCE3 | ONE CENTRAL STREET SUITE 205 MIDDLETON, MA 01949 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $35K | $1K | $36K | 1.96% |
| DESIGNED BENEFITS INSURANCE3 | ONE CENTRAL STREET SUITE 205 MIDDLETON, MA 01949 | METROPLITAN LIFE INSURANCE COMPANY | $15K | — | $15K | 4.53% |
| INDIGO INSURANCE SVC3 Filed as: INDIGO INSURANCE SERVICE | 446 MAIN STREET 5TH FLOOR WORCESTER, MA 01608 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $14K | — | $14K | 7.00% |
| DESIGNED BENEFITS INSURANCE3 | ONE CENTRAL STREET SUITE 205 MIDDLETON, MA 01949 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $13K | — | $13K | 6.33% |
| DESIGNED BENEFITS INSURANCE3 | ONE CENTRAL STREET SUITE 205 MIDDLETON, MA 01949 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 6.22% |
| ALAN C SHRAYER3 | 30 LEDGEWOOD DRIVE DOUGLAS, MA 01516 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $25 | — | $25 | 0.06% |
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 | 731 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 731 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 519 | $1.8M |
| Dental | METROPLITAN LIFE INSURANCE COMPANY | 1,011 | $322K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 479 | $42K |
| Life insurance(2 contracts, 2 carriers) | METROPLITAN LIFE INSURANCE COMPANY | 1,011 | $521K |
| Short-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 731 | $199K |
| Long-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 731 | $199K |
| Other(2 contracts, 2 carriers) | METROPLITAN LIFE INSURANCE COMPANY | 1,011 | $521K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,011 | — |
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.