| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRED C. CHURCH INC.3 Filed as: FRED C. CHURCH, INC. | 41 WELLMAN STREET LOWELL, MA 01851 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $72K | $21K | $93K | 3.87% |
| FRED C. CHURCH INC.3 Filed as: FRED C. CHURCH, INC. | 41 WELLMAN STREET LOWELL, MA 01851 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $5K | — | $5K | 3.98% |
| FRED C. CHURCH INC.3 Filed as: FRED C. CHURCH, INC. | 41 WELLMAN STREET LOWELL, MA 01851 | FIDELITY SECURITY LIFE | $928 | — | $928 | 8.13% |
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 | 256 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 256 | $2.4M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 210 | $122K |
| Vision | FIDELITY SECURITY LIFE | 182 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 256 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.