| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HJ KNIGHT INTERNATIONAL Filed as: HJ KNIGHT INTERNATIONAL INS | — | HARVARD PILGRIM HEALTH CARE | $29K | — | $29K | 1.40% |
| HJ DIMOS & ASSOCIATES | — | HARVARD PILGRIM HEALTH CARE | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CHRISTOPHER BROUSAIDES EIN 04-6049991 ADMINISTRATOR | Employee (plan) Service code 30 | 7 FREDERIKA STREET BOSTON, MA 02124 | $29K |
| CAMPBELL DEVASTO & ASSOCIATES CPA EIN 04-2779892 NONE | Accounting (including auditing) Service code 10 | 175 DERBY STREET UNIT 2 HINGHAM, MA 02043 | $19K |
| GAIL MILLS EIN 04-6049991 ASSISTANT ADMINISTRATOR | Employee (plan) Service code 30 | 7 FREDERIKA STREET BOSTON, MA 02124 | $18K |
| THE SAVITZ ORGANIZATION EIN 26-1371674 NONE | Actuarial Service code 11 | 1845 WALNUT STREET PHILADELPHIA, PA 19103 | $15K |
| KRAKOW & SOURIS LLC EIN 04-3363718 NONE | Legal Service code 29 | 225 FRIEND STREET BOSTON, MA 02114 | $14K |
| ISSI EIN 23-2182079 NONE | Other fees Service code 99 | TWO EXECUTIVE CAMPUS 400 CHERRY HILL, NJ 08002 | $14K |
| JAMIE BEARS EIN 04-6049991 ASSISTANT ADMINISTRATOR | Employee (plan) Service code 30 | 7 FREDERIKA STREET BOSTON, MA 02124 | $13K |
| BOSTON TRUST INVESTMENT MGMT COMPAN EIN 04-2273811 NONE | Investment management fees paid directly by plan; Trustee (bank, trust company, or similar financial institution); Trustee (discretionary); Investment management; Trustee (directed); Custodial (securities); Direct payment from the plan Service code 19 | 1 BEACON STREET BOSTON, MA 02108 | $4K |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 56 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 447 | $2.1M |
| Dental | ALTUS DENTAL INSURANCE COMPANY, INC. | 456 | $109K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 241 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 456 | — |
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.