| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE 1ST FLOOR FLORHAM PARK, NJ 07932 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $20K | $3K | $23K | 1.58% |
| LOCKTON COMPANIES, LLC | 7 G GATTERSON PARK ROAD SUITE 3 FARMINGTON, CT 06032 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $22K | $0 | $22K | 1.53% |
| LOCKTON COMPANIES, LLC3 | 7 G GATTERSON PARK ROAD SUITE 3 FARMINGTON, CT 06032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $489 | $6K | 11.91% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE 1ST FLOOR FLORHAM PARK, NJ 07932 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 4.07% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 11788 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $166 | $166 | 0.33% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $598 | $0 | $598 | 4.07% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | VISION SERVICE PLAN | $516 | $0 | $516 | 3.51% |
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 | 90 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 175 | $1.5M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 175 | $1.5M |
| Vision | VISION SERVICE PLAN | 103 | $15K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 95 | $50K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 95 | $50K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 95 | $50K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 175 | $1.5M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 95 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.