| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND | 931 JEFFERSON BLVD SUITE 3001 WARWICK, RI 02886 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $21K | — | $21K | 2.83% |
| SAPERS & WALLACK3 | 275 WASHINGTON STREET SUITE 110 NEWTON, MA 02458 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | — | $9K | $9K | 1.23% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND | 931 JEFFERSON BLVD SUITE 3001 WARWICK, RI 02886 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $4K | — | $4K | 4.37% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND | 931 JEFFERSON BLVD SUITE 3001 WARWICK, RI 02886 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 13.10% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC. | 1250 CAPITAL OF TX HIGHWAY S BLDG II, SUITE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $227 | $227 | 0.93% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND | 931 JEFFERSON BLVD SUITE 3001 WARWICK, RI 02886 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 10.21% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TX HIGHWAY S BLDG II, SUITE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $191 | $191 | 0.91% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND | 931 JEFFERSON BLVD SUITE 3001 WARWICK, RI 02886 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 10.28% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC. | 1250 CAPITAL OF TX HIGHWAY S BLDG II, SUITE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $112 | $112 | 0.91% |
| SAPERS & WALLACK3 | 275 WASHINGTON STREET SUITE 110 NEWTON, MA 02458 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $727 | — | $727 | 9.06% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND | 931 JEFFERSON BLVD SUITE 3001 WARWICK, RI 02886 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $77 | — | $77 | 9.95% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC. | 1250 CAPITAL OF TX HIGHWAY S BLDG II, SUITE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $5 | $5 | 0.65% |
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 | 124 | 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) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 155 | $743K |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 170 | $80K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 121 | $8K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 124 | $13K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 124 | $21K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 124 | $25K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 124 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.