No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MASS, INC EIN 04-1045815 NONE | Claims processing Service code 12 | 401 PARK DRIVE BOSTON, MA 022153326 | $406K |
| ROOFERS UNION LOCAL NO. 3 ADMISTR EIN 04-2628775 JOINT OPERATING FUND | Plan Administrator Service code 14 | 53 EVANS DRIVE STOUGHTON, MA 02072 | $133K |
| CBIZ BENEFITS & INSURANCE SERVICE, EIN 31-1582098 NONE | Actuarial Service code 11 | 6050 OAK TREE BLVD, STE 500 CLEVELAND, OH 44131 | $30K |
| CAMPANA, SARZA & TATEWOSIAN, LLP EIN 05-0392492 NONE | Accounting (including auditing) Service code 10 | 300 METRO CENTER BLVD., ST.225 WARWICK, RI 02886 | $23K |
| KRAKOW & SOURIS EIN 04-3363718 NONE | Legal Service code 29 | 225 FRIEND STREET BOSTON, MA 02114 | $19K |
| HJ KNIGHT INTERNATIONAL INSURANCE A EIN 04-2960092 NONE | Consulting (general) Service code 16 | 30 BRAINTREE HILL OFFICE PARK,ST203 BRAINTREE, MA 02184 | $13K |
| SEGAL ADVISORS, INC. EIN 13-2646110 NONE | Investment advisory (plan) Service code 27 | 333 WEST 34TH STREET NEW YORK, NY 100012402 | $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 | 594 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 100 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 694 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 7 | $19K |
| Dental | DELTA DENTAL OF MASSACHUSETTS | 1,031 | $0 |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 394 | $60K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 594 | $1.2M |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 394 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,031 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.