| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INDIGO INSURANCE SERVICES | 445 MAIN STREET 5TH FL WORCESTER, MA 01608 | SYMETRA LIFE INSURANCE COMPANY | $19K | — | $19K | 3.96% |
| BROWN AND BROWN OF FLORIDA, INC. Filed as: BROWN & BROWN OF MASSACHUSETTS | 144 TURNPIKE RD SOUTHBOROUGH, MA 01772 | SYMETRA LIFE INSURANCE COMPANY | — | $10K | $10K | 1.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 04-1045815 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $1.7M |
| VITECH SYSTEMS GROUP, INC. EIN 13-3785492 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $459K |
| MODERN ASSISTANCE PROGRAMS, INC. EIN 04-3014253 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $422K |
| STRATEGIC BENEFIT ADVISORS, INC EIN 14-1849341 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $106K |
| EMPLOYEE A EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $84K |
| EMPLOYEE J EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $65K |
| SEGAL ROITMAN, LLP EIN 04-2489114 NONE | Legal; Direct payment from the plan Service code 29 | — | $62K |
| MORGAN STANLEY EIN 26-4310632 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $60K |
| EPIC HEARING HEALTHCARE EIN 95-4660712 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $48K |
| MANZI & ASSOCIATES, LLC EIN 04-3508036 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $48K |
| EMPLOYEE M EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $44K |
| CVS HEALTH EIN 05-0340626 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $44K |
| CBIZ RETIREMENT PLAN SERVICES EIN 31-1582098 NONE | Actuarial; Direct payment from the plan; Consulting fees; Consulting (general) Service code 11 | — | $42K |
| EMPLOYEE T EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $39K |
| EMPLOYEE B EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $36K |
| VSG HOSTING INC EIN 20-4487588 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $35K |
| EMPLOYEE K EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $33K |
| EMPLOYEE P EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $31K |
| HEALTHLINX EIN 87-0660214 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $30K |
| EMPLOYEE I EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $30K |
| DAVIS VISION, INC. EIN 11-3051991 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $27K |
| EMPLOYEE O EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $24K |
| RAPID7, INC EIN 35-2423994 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $21K |
| EMPLOYEE Q EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $19K |
| EMPLOYEE C EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $19K |
| EMPLOYEE D EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $19K |
| EMPLOYEE S EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $19K |
| THE BOSTON COMPANY EIN 04-3404987 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $17K |
| EMPLOYEE E EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $15K |
| SEGAL MARCO ADVISORS EIN 13-1835864 NONE | Investment management; Direct payment from the plan Service code 28 | — | $15K |
| THE STAYWELL COMPANY LLC EIN 94-3151780 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $15K |
| CTS SERVICES EIN 04-3068502 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $15K |
| EMPLOYEE R EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $13K |
| EMPLOYEE G EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $13K |
| WALLINGFORD PRODIGY INC EIN 20-6800093 NONE | Other services; Direct payment from the plan Service code 49 | — | $13K |
| EMPLOYEE H EIN 04-6040880 EMPLOYEE | Employee (plan) Service code 30 | — | $12K |
| STATE STREET BANK & TRUST CO EIN 04-1867445 NONE | Investment management; Non-monetary compensation; Custodial (securities); Distribution (12b-1) fees; Investment management fees paid indirectly by plan; Float revenue; Investment management fees paid directly by plan; Other fees; Trustee (directed) Service code 19 | — | $10K |
| HANNAFORD & DUMAS EIN 04-2593260 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $9K |
| IRON MOUNTAIN RECORDS MANAGEMENT EIN 04-3038590 NONE | Other services; Direct payment from the plan Service code 49 | — | $6K |
| STATE STREET GLOBAL ADVISORS EIN 04-1867445 NONE | Custodial (other than securities); Investment management fees paid indirectly by plan; Other fees; Investment management fees paid directly by plan; Custodial (securities); Soft dollars commissions Service code 18 | — | $6K |
| JOURNEYMAN PRESS EIN 04-2802514 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $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 | 3,134 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 64 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 2,813 | $486K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 3,177 | $632K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 2,813 | $486K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,177 | — |
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."
No prospect flags tripped on this filing.