| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INDIGO INSURANCE SERVICES | 446 MAIN ST 5TH FL WORCESTER, MA 01608 | SYMETRA LIFE INSURANCE COMPANY | $19K | — | $19K | 4.00% |
| BROWN AND BROWN OF FLORIDA, INC. Filed as: BROWN & BROWN OF MASSACHUSETTS | 144 TURNPIKE RD SOUTHBOROUGH, MA 01772 | SYMETRA LIFE INSURANCE COMPANY | — | $8K | $8K | 1.66% |
| INDIGO INSURANCE SERVICES3 | 5TH FLOOR, 446 MAIN STREET WORCESTER, MA 01608 | AMERICAN GENERAL LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 04-1045815 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $1.6M |
| VSG HOSTING INC EIN 20-4487588 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $360K |
| STRATEGIC BENEFIT ADVISORS, INC EIN 14-1849341 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $80K |
| EMPLOYEE A EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $78K |
| MODERN ASSISTANCE PROGRAMS, INC. EIN 04-3014253 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $70K |
| VITECH SYSTEMS GROUP, INC. EIN 13-3785492 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $69K |
| EMPLOYEE T EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $61K |
| HEALTHLINX EIN 87-0660214 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $60K |
| EMPLOYEE H EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| EMPLOYEE R EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
| SEGAL ROITMAN, LLP EIN 04-2489114 NONE | Legal; Direct payment from the plan Service code 29 | — | $49K |
| MORGAN STANLEY EIN 26-4310632 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $45K |
| CVS HEALTH EIN 05-0340626 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $45K |
| EMPLOYEE K EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $43K |
| THE BOSTON COMPANY EIN 04-3404987 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $43K |
| MANZI & ASSOCIATES, LLC EIN 04-3508036 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $42K |
| EMPLOYEE S EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $36K |
| EMPLOYEE L EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $35K |
| EMPLOYEE B EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $35K |
| EMPLOYEE I EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $31K |
| EMPLOYEE N EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $30K |
| CBIZ RETIREMENT PLAN SERVICES EIN 31-1582098 NONE | Actuarial; Consulting fees; Direct payment from the plan; Consulting (general) Service code 11 | — | $29K |
| EMPLOYEE G EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $28K |
| DAVIS VISION, INC. EIN 11-3051991 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $26K |
| EMPLOYEE M EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $23K |
| STATE STREET BANK & TRUST CO EIN 04-1867445 NONE | Non-monetary compensation; Trustee (directed); Investment management; Custodial (securities); Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Other fees; Distribution (12b-1) fees; Float revenue Service code 19 | — | $19K |
| GROOM LAW GROUP EIN 52-1219029 NONE | Legal; Direct payment from the plan Service code 29 | — | $19K |
| EMPLOYEE O EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $18K |
| EMPLOYEE C EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $18K |
| EMPLOYEE P EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $18K |
| EPIC HEARING HEALTHCARE EIN 95-4660712 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $17K |
| MD SASS EIN 13-2704843 NONE | Direct payment from the plan; Investment management Service code 28 | — | $15K |
| EMPLOYEE D EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $14K |
| THE STAYWELL COMPANY LLC EIN 94-3151780 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $14K |
| SEGAL MARCO ADVISORS EIN 13-1835864 NONE | Investment management; Direct payment from the plan Service code 28 | — | $14K |
| EMPLOYEE E EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $11K |
| EMPLOYEE J EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $9K |
| HANNAFORD & DUMAS EIN 04-2593260 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $9K |
| EMPLOYEE F EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $8K |
| WALLINGFORD PRODIGY INC EIN 20-6800093 NONE | Other services; Direct payment from the plan Service code 49 | — | $8K |
| CTS SERVICES EIN 04-3068502 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $8K |
| IRON MOUNTAIN RECORDS MANAGEMENT EIN 04-3038590 NONE | Direct payment from the plan; Other services Service code 49 | — | $8K |
| JOURNEYMAN PRESS EIN 04-2802514 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $7K |
| STATE STREET GLOBAL ADVISORS EIN 04-1867445 NONE | Other fees; Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Custodial (securities); Soft dollars commissions; Custodial (other than securities) Service code 18 | — | $5K |
| SEGAL SELECT INSURANCE SERVICES EIN 46-0619194 NONE | Insurance brokerage commissions and fees Service code 53 | — | $0 |
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 | 2,981 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 51 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,032 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 2,799 | $663K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 2,984 | $586K |
| Other(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 2,799 | $663K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,984 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.