| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LORETTA HO SHERBLOM INS AGENCY INC3 | 199 PARK LANE CONCORD, MA 01742 | TUFTS ASSOCIATED HEALTH MAINTANANCE ORG., INC. | $83K | $0 | $83K | 1.20% |
| LORETTA HO SHERBLOM INS AGENCY INC3 | 199 PARK LANE CONCORD, MA 01742 | TUFTS INSURANCE COMPANY | $8K | $0 | $8K | 1.10% |
| LORETTA HO SHERBLOM INS AGENCY INC3 | 199 PARK LANE CONCORD, MA 01742 | HARTFORD LIFE AND ACCIDENT | $21K | $0 | $21K | 3.47% |
| LORETTA HO SHERBLOM INS AGENCY INC3 | 199 PARK LANE CONCORD, MA 01742 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | $0 | $5K | 9.14% |
| LORETTA HO SHERBLOM INS AGENCY INC3 | 199 PARK LANE CONCORD, MA 01742 | FEDERAL INSURANCE COMPANY | $63 | $0 | $63 | 15.04% |
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 | 797 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 797 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTANANCE ORG., INC. | 1,243 | $7.7M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 864 | $51K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 797 | $611K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 797 | $611K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 797 | $611K |
| Prescription drug(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTANANCE ORG., INC. | 1,243 | $7.7M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 797 | $612K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,243 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.