| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 446 MAIN ST 5TH FL WORCESTER, MA 01608 | SYMETRA LIFE INSURANCE COMPANY | $26K | — | $26K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MASS EIN 04-1045815 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $2.0M |
| WILLIS TOWERS WATSON, NORTHEAST INC EIN 13-2695427 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $175K |
| PRUDENT RX EIN 95-4477265 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $137K |
| MODERN ASSISTANCE PROGRAMS, INC. EIN 04-3014253 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $135K |
| VITECH SYSTEMS SUB, LLC EIN 13-3785492 NONE | Direct payment from the plan; Other services Service code 49 | — | $125K |
| CVS PHARMACY, INC EIN 05-0340626 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $118K |
| LIVONGO EIN 26-3542036 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $115K |
| GREGORY A GEIMAN EIN 04-6040880 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $104K |
| MORGAN STANLEY SMITH BARNEY LLC EIN 11-3658445 NONE | Securities brokerage; Investment management; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Other commissions; Investment management fees paid directly by plan; Recordkeeping fees; Other fees Service code 15 | — | $93K |
| LAW OFFICE OF KATHRYN S. SHEA EIN 86-2611553 LEGAL | Legal; Direct payment from the plan Service code 29 | — | $83K |
| LYRA HEALTH EIN 47-2935915 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $73K |
| REBECCA ZACCARDI EIN 04-6040880 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $66K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $57K |
| DONALD R CHRISTY EIN 04-6040880 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $54K |
| LAURA JEAN HICKEY EIN 04-6040880 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $52K |
| VSG HOSTING SUB, LLC EIN 20-4487588 NONE | Other services; Direct payment from the plan Service code 49 | — | $49K |
| O'DONOGHUE & O'DONOGHUE EIN 53-0120528 NONE | Legal; Direct payment from the plan Service code 29 | — | $47K |
| JAMES M BURNS EIN 04-6040880 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $45K |
| WENDY BATCHELDER EIN 04-6040880 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $40K |
| HEALTHLINX LLC EIN 87-0660214 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $39K |
| DEREK OETINGER EIN 04-6040880 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $38K |
| CBIZ BENEFITS & INSURANCE SERVICES, EIN 31-1582098 NONE | Consulting fees; Direct payment from the plan; Consulting (general); Actuarial Service code 11 | — | $35K |
| IRON MOUNTAIN EIN 23-2588479 NONE | Direct payment from the plan; Other services Service code 49 | — | $31K |
| 617 MEDIA GROUP EIN 90-1252805 NONE | Direct payment from the plan; Other services Service code 49 | — | $31K |
| KAREN L LARSEN EIN 04-6040880 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $30K |
| EYEMED EIN 31-1656473 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $17K |
| KROLL ASSOCIATES EIN 11-2286880 NONE | Direct payment from the plan; Other services Service code 49 | — | $17K |
| CTS SERVICES INC. EIN 04-3068502 NONE | Direct payment from the plan; Other services Service code 49 | — | $15K |
| SEGAL MARCO ADVISORS EIN 13-2646110 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $14K |
| STATE STREET GLOBAL ADVISORS EIN 81-4017137 NONE | Custodial (securities); Investment management fees paid indirectly by plan; Investment management fees paid directly by plan Service code 19 | — | $13K |
| MCMC SERVICES, LLC EIN 85-2321015 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $9K |
| SEGAL SELECT INSURANCE SERVICES INC EIN 46-0619194 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $8K |
| ASCENDO RESOURCES LLC EIN 27-0455328 NONE | Direct payment from the plan; Other services Service code 49 | — | $7K |
| BAKER & HOSTETLER LLP EIN 34-0082025 NONE | Legal; Direct payment from the plan Service code 29 | — | $5K |
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 | 3,952 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 60 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,012 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 3,952 | $523K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 3,659 | $2.0M |
| Other | SYMETRA LIFE INSURANCE COMPANY | 3,952 | $523K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,952 | — |
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.