| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE GAUDREAU GROUP INC.3 Filed as: THE GAUDREAU GROUP, INC. | 2377 BOSTON ROAD PO BOX 369 WILBRAHAM, MA 01095 | EXPRESS SCRIPTS, INC. | $930 | — | $930 | 3.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MA EIN 04-1045815 NONE | Direct payment from the plan; Contract Administrator; Other fees Service code 13 | — | $220K |
| INSURANCE PROGRAMMERS EIN 06-0811449 NONE | Plan Administrator; Direct payment from the plan; Consulting fees Service code 14 | — | $45K |
| DELTA DENTAL OF MASSACHUSETTS EIN 04-6143185 NONE | Direct payment from the plan; Contract Administrator; Other fees Service code 13 | — | $40K |
| NICHOLAS LAPIER, CPA, PC EIN 32-0048525 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $16K |
| ENVISION PHARMACEUTICAL SERVICES EIN 05-0570786 NONE | Other fees; Contract Administrator; Direct payment from the plan Service code 13 | — | $15K |
| KRAKOW & SOURIS EIN 04-3363718 NONE | Legal; Direct payment from the plan Service code 29 | — | $13K |
| THE GAUDREAU GROUP, INC. EIN 04-2224848 NONE | Consulting fees; Consulting (general); Direct payment from the plan Service code 16 | — | $10K |
| PENSION & HEALTH ASSOCIATES, INC. EIN 04-2423112 NONE | Consulting (general); Consulting fees; Direct payment from the plan Service code 16 | — | $7K |
| THE SAVITZ ORGANIZATION OF MA, INC. EIN 26-1371674 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $7K |
| THE HARTFORD EIN 06-0838648 NONE | Direct payment from the plan; Other fees; Contract Administrator Service code 13 | — | $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 | 374 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 374 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 336 | $38K |
| Other | EXPRESS SCRIPTS, INC. | 91 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 336 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.