| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EASTERN INSURANCE GROUP LLC3 | 607 NORTH AVENUE, PO BOX 4000 WAKEFIELD, MA 01880 | TUFTS ASSOCIATED HEALTH MAINTANANCE ORG. INC. | $9K | $3K | $12K | 2.94% |
| EASTERN INSURANCE GROUP LLC3 | 607 NORTH AVENUE, PO BOX 4000 WAKEFIELD, MA 01880 | TUFTS INSURANCE COMPANY | $5K | $1K | $6K | 4.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL | $2K | $126 | $2K | 3.24% |
| EASTERN INSURANCE GROUP LLC3 | 233 W CENTRAL ST NATICK, MA 01760 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $994 | $4K | 10.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 3.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $598 | $0 | $598 | 1.86% |
| EASTERN INSURANCE GROUP LLC3 | 233 W CENTRAL ST NATICK, MA 01760 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $703 | $2K | 15.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $693 | $0 | $693 | 5.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $345 | $345 | 2.95% |
| EASTERN INSURANCE GROUP LLC3 | 233 W CENTRAL ST NATICK, MA 01760 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $627 | $596 | $1K | 11.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $406 | $0 | $406 | 3.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $292 | $292 | 2.83% |
| EASTERN INSURANCE GROUP LLC3 | 233 W CENTRAL ST NATICK, MA 01760 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $444 | $438 | $882 | 12.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $288 | $0 | $288 | 3.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $215 | $215 | 2.94% |
| EASTERN INSURANCE GROUP LLC3 | 233 W CENTRAL ST NATICK, MA 01760 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $134 | $96 | $230 | 16.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $69 | $0 | $69 | 5.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $56 | $56 | 4.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 2.55% |
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 | 66 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 66 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTANANCE ORG. INC. | 66 | $557K |
| Dental | DELTA DENTAL OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL | 78 | $51K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 51 | $9K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 51 | $11K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 51 | $12K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 51 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 78 | — |
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."
No prospect flags tripped on this filing.