| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND Filed as: HILB GROUP OF NEW ENGLAND LLC | 2000 CHAPEL VIEW DRIVE BLVD, SUITE CRANSTON, RI 02920 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | — | — | $0 | 0.00% |
| HILB GROUP OF NEW ENGLAND Filed as: THE HILB GROUP OF NE, LLC | 2000 CHAPEL VIEW DR SUITE 240 CRANSTON, RI 02920 | ALTUS DENTAL INSURANCE COMPANY, INC. | $2K | — | $2K | 4.01% |
| HILB GROUP OF NEW ENGLAND Filed as: HILB GROUP OF NEW ENGLAND LLC | — | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $4K | — | $4K | 16.59% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 100 FRONT STREET 20TH FLOOR WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 7.14% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND | 30 BRAINTREE HILL OFFICE PARK BRAINTREE, MA 02184 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 5.10% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND | 2000 CHAPEL VIEW BLVD SUITE 240 CRANSTON, RI 02920 | HARTFORD LIFE AND ACCIDENT | — | $520 | $520 | 2.61% |
| HILB GROUP OF NEW ENGLAND Filed as: THE HILB GROUP OF NE LLC | 2000 CHAPEL VIEW DR STE 240 CRANSTON, RI 02920 | ALTUS DENTAL INSURANCE COMPANY | $5K | — | $5K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MASSACHUS EIN 04-1045815 N/A | Claims processing Service code 12 | — | $171K |
| GAIL MILLS EIN 04-6049991 PLAN ADMINISTRATOR | Employee (plan) Service code 30 | 7 FREDERIKA STREET BOSTON, MA 02124 | $42K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 23-2182079 NONE | Recordkeeping fees Service code 64 | TWO EXECUTIVE CAMPUS 400 CHERRY HILL, NJ 08002 | $28K |
| BOSTON TRUST WALDEN COMPANY EIN 04-2273811 NONE | Trustee (directed); Investment management fees paid directly by plan; Trustee (bank, trust company, or similar financial institution); Direct payment from the plan; Custodial (securities); Trustee (discretionary); Investment management Service code 19 | 1 BEACON STREET BOSTON, MA 02108 | $27K |
| AIMEE LINCOLN EIN 04-6049991 ASSISTANT ADMINISTRATOR | Employee (plan) Service code 30 | 7 FREDERIKA STREET BOSTON, MA 02124 | $25K |
| CBIZ SAVITZ EIN 26-1371674 NONE | Actuarial Service code 11 | 1845 WALNUT STREET PHILADELPHIA, PA 19103 | $24K |
| CAMPBELL DEVASTO & ASSOCIATES CPA EIN 04-2779892 NONE | Accounting (including auditing) Service code 10 | 175 DERBY STREET UNIT 2 HINGHAM, MA 02043 | $23K |
| LAUREN BLUNDELL EIN 04-6049991 ADMINISTRATIVE ASSISTANT | Employee (plan) Service code 30 | 7 FREDERIKA STREET BOSTON, MA 02108 | $20K |
| KRAKOW & SOURIS LLC EIN 04-3363718 NONE | Legal Service code 29 | 225 FRIEND STREET BOSTON, MA 02114 | $16K |
| ALTUS DENTAL EIN 05-0513223 NONE | Claims processing; Direct payment from the plan Service code 12 | 10 CHARLES STREET PROVIDENCE, RI 029042208 | $13K |
| BOLTON USA EIN 48-0797599 NONE | Other fees Service code 99 | 960 HARVEST BLDG 5 WEST BLUE BELL, PA 19422 | $12K |
| MODERN ASSISTANCE EIN 04-3014253 N/A | Direct payment from the plan; Consulting (general) Service code 16 | 300 CONGRESS ST. STE 104 QUINCY, MA 02169 | $12K |
| VICTORIA GRIGNON EIN 04-6049991 ADMINISTRATIVE ASSISTANT | Employee (plan) Service code 30 | 7 FREDERIKA STREET BOSTON, MA 02124 | $10K |
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 | 212 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 58 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 270 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | ALTUS DENTAL INSURANCE COMPANY, INC. | 536 | $54K |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 495 | $23K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 301 | $20K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 301 | $20K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 0 | $609K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 536 | — |
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.