| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE BENEFIT ADMINISTRATORS OF MA | — | HCC | — | $53K | $53K | 27.06% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICE | — | HCC | — | $12K | $12K | 6.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NE LLC | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | LINCOLN FINANCIAL GROUP | $5K | — | $5K | 6.36% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET, SUITE 400 NEI GENERAL, MA 02184 | EYEMED | $2K | — | $2K | 11.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE BENEFIT OF MASSACHUSETTS CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 55917 BOSTON, MA 02205 | $12K |
| BAYSTATE BENEFIT SERVICES BROKER | Insurance agents and brokers Service code 22 | 400 WASHINGTON STREET, STE 400 BRAINTREE, MA 02184 | $4K |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC | 121 | $196K |
| Vision | EYEMED | 277 | $18K |
| Life insurance | LINCOLN FINANCIAL GROUP | 206 | $80K |
| Short-term disability | LINCOLN FINANCIAL GROUP | 206 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 277 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.