| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 100 FRONT STREET SUITE 800 WORCESTER, MA 01608 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $43K | $19K | $62K | 2.38% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 100 FRONT STREET SUITE 800 WORCESTER, MA 01608 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. - SENIOR | $6K | — | $6K | 4.24% |
| INDIGO INSURANCE SERVICES3 | 401 PARK DRIVE BOSTON, MA 02215 | USABLE LIFE | $5K | — | $5K | 17.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 100 FRONT STREET SUITE 800 WORCESTER, MA 01608 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 37.10% |
| INDIGO INSURANCE SERVICES3 | 401 PARK DRIVE BOSTON, MA 02215 | USABLE LIFE | $3K | — | $3K | 17.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INSURANCE PROGRAMMERS INC. EIN 06-0811449 THIRD PARTY ADMINISTRATOR | Insurance services Service code 23 | — | $51K |
| GOULET, SALVIDIO & ASSOCIATES EIN 04-2633065 ACCOUNTANT | Accounting (including auditing) Service code 10 | — | $34K |
| TD WEALTH MANAGEMENT EIN 03-0349319 INVESTMENT MANAGER | Investment management Service code 28 | — | $26K |
| ROBERT M. CHEVERIE & ASSOCIATES EIN 06-1335139 ATTORNEY | Legal Service code 29 | — | $25K |
| SEGAL ADVISORS DBA SEGAL ROGERCASEY EIN 13-2646110 INVESTMENT CONSULTANT | Investment advisory (plan) Service code 27 | — | $10K |
| SEGAL COMPANY EIN 13-1835864 ACTUARY | Actuarial Service code 11 | — | $10K |
| SEGAL SELECTION INSURANCE SERVICES EIN 46-0619194 INSURANCE BROKER | Insurance brokerage commissions and fees Service code 53 | — | $7K |
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 | 172 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 67 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 150 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 389 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 180 | $2.9M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 212 | $21K |
| Life insurance | USABLE LIFE | 386 | $32K |
| Short-term disability | USABLE LIFE | 283 | $17K |
| Prescription drug(5 contracts, 5 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 180 | $3.0M |
| Other | USABLE LIFE | 386 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 386 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.