| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOCIATES | UNKNOWN QUINCY, MA 02171 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $125K | $45K | $170K | 1.93% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INS. DBA RISK STRATEGIES CO. | 160 FEDERAL STREET, 2ND FLOOR BOSTON, MA 02210 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $31K | — | $31K | 0.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE, 13TH FLOOR BOSTON, MA 02210 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $17K | — | $17K | 0.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WILLIAM GALLAGHER ASSOC. INS. BRKRS | 470 ATLANTIC AVENUE, 13TH FLOOR BOSTON, MA 02210 | METROPOLITAN LIFE INSURANCE COMPANY | $30K | — | $30K | 11.38% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 2ND FLOOR BOSTON, MA 02110 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $1K | $10K | 3.73% |
| MICHAEL P TSOTSIS3 Filed as: MICHAEL TSOTSIS | 446 MAIN STREET, SUITE 19 WORCHESTER, MA 01608 | METROPOLITAN LIFE INSURANCE COMPANY | -$82 | — | -$82 | -0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | HYATT LEGAL PLANS | $400 | — | $400 | 7.40% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 2ND FLOOR BOSTON, MA 02110 | HYATT LEGAL PLANS | $230 | — | $230 | 4.25% |
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 | 1,690 | 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) | 1,690 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,919 | $8.8M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,919 | $8.8M |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,919 | $8.8M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,690 | $261K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,690 | $261K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,690 | $261K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,919 | $8.8M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,690 | $266K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,919 | — |
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.