| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | — | SYMETRA LIFE INSURANCE COMPANY | $21K | $0 | $21K | 6.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MA, INC. EIN 04-1045815 NONE | Claims processing; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $5.4M |
| DELTA DENTAL OF MA EIN 04-6143185 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $735K |
| NE CARPENTERS PENSION FUND (CCA) EIN 51-6040899 COMMON BOARD | Plan Administrator; Direct payment from the plan Service code 14 | — | $606K |
| THE SEGAL COMPANY (EASTERN STATES) EIN 13-1835864 NONE | Direct payment from the plan; Actuarial; Consulting (general) Service code 11 | — | $379K |
| EXPRESS SCRIPTS, INC EIN 22-3461740 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $229K |
| KGA, INC. EIN 04-3526805 NONE | Other services; Direct payment from the plan Service code 49 | — | $157K |
| ANTHEM HEALTH PLANS, INC. EIN 06-1475928 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Insurance services; Other services; Claims processing; Insurance brokerage commissions and fees; Other commissions; Contract Administrator Service code 12 | — | $154K |
| MELLON INVESTMENTS CORPORATION EIN 25-1442864 NONE | Investment management; Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Soft dollars commissions Service code 28 | — | $109K |
| KRAKOW, SOURIS & LANDRY, LLC EIN 04-3363718 NONE | Legal; Direct payment from the plan Service code 29 | — | $90K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $87K |
| DODGE & COX INVESTMENT MANAGERS EIN 94-1441976 NONE | Investment management fees paid directly by plan; Soft dollars commissions; Investment management Service code 28 | — | $78K |
| LOOMIS, SAYLES & COMPANY EIN 04-3200030 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $75K |
| THE TRIZETTO GROUP EIN 33-0761159 NONE | Direct payment from the plan; Other services; Consulting (general) Service code 16 | — | $71K |
| O'REILLY, GROSSO, GROSS & JONES, PC EIN 04-3318596 NONE | Legal; Direct payment from the plan Service code 29 | — | $70K |
| STATE STREET BANK & TRUST CO. EIN 04-1867445 NONE | Float revenue; Investment management; Other fees; Distribution (12b-1) fees; Investment management fees paid indirectly by plan; Custodial (securities); Direct payment from the plan Service code 19 | — | $63K |
| DAVIS VISION, INC. EIN 11-3051991 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $60K |
| WELLINGTON TRUST COMPANY NA EIN 04-2755549 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $56K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $44K |
| THE WAGNER LAW GROUP EIN 04-3323315 NONE | Legal; Direct payment from the plan Service code 29 | — | $35K |
| BLACKROCK INSTL TRUST COMPANY, N.A. EIN 94-3112180 NONE | Direct payment from the plan; Investment management fees paid directly by plan; Trustee (bank, trust company, or similar financial institution); Investment management; Trustee (discretionary) Service code 21 | — | $28K |
| BENESYS, INC EIN 38-2383171 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $20K |
| DIPLOMAT SPECIALTY PHARMACY EIN 38-2063100 NONE | Other services; Direct payment from the plan Service code 49 | — | $14K |
| THE JOURNEYMAN PRESS EIN 46-5227450 NONE | Direct payment from the plan; Other services Service code 49 | — | $14K |
| BANK OF AMERICA N.A. EIN 94-1687665 NONE | Direct payment from the plan; Custodial (other than securities) Service code 18 | — | $13K |
| SEGAL SELECT INSURANCE SVCS, INC. EIN 46-0619194 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Insurance services Service code 22 | — | $10K |
| HYGRADE BUSINESS GROUP, INC. EIN 22-2392031 NONE | Other services; Direct payment from the plan Service code 49 | — | $10K |
| DR. WAYNE FOWLER NONE | Legal; Direct payment from the plan Service code 29 | 22 ROCKY HILL RD ANDOVER, MA 01810 | $8K |
| PALO INFORMATICS LLC EIN 46-2647728 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $6K |
| DELTA DENTAL OF NEW JERSEY, INC. EIN 22-1896118 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $5K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Direct payment from the plan; Claims processing; Other fees; Float revenue Service code 12 | — | $1K |
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 | 18,754 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,367 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 21,121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 11,254 | $807K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 11,254 | $807K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 11,254 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.