| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC. | $75K | — | $75K | 3.32% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | TUFTS INSURANCE COMPANY | $17K | — | $17K | 3.06% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $20K | — | $20K | 15.00% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| FRED C. CHURCH INC.3 | 41 WELLMAN STREET CONNECTOR PARK LOWELL, MA 01851 | EYEMED VISION CARE | $2K | — | $2K | 10.79% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF MASSACHUSETTS, INC. EIN 04-6143185 THIRD PARTY ADMINISTRATO | Claims processing; Contract Administrator Service code 12 | 465 MEDFORD STREET BOSTON, MA 02129 | $30K |
| BENEFIT STRATEGIES, LLC EIN 26-0003294 THIRD PARTY ADMINSTRATOR | Claims processing Service code 12 | PO BOX 1300 MANCHESTER, NH 03101 | $7K |
| FRED C. CHURCH INC. EIN 04-2445292 BROKER | Insurance agents and brokers Service code 22 | 41 WELLMAN STREET LOWELL, MA 01851 | $6K |
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 | 374 | 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) | 374 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC. | 371 | $2.8M |
| Vision | EYEMED VISION CARE | 298 | $21K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 374 | $29K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 357 | $133K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 372 | $42K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 374 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 374 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.