| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DBR GROUP3 Filed as: DBR GROUP INC | 959 CONCORD STREET, SUITE 220 FRAMINGHAM, MA 01701 | BLUE CROSS BLUE SHIELD OF MASS. | $847K | $2K | $850K | 0.94% |
| KEVIN M HARRINGTON3 Filed as: KEVIN M. HARRINGTON | 770 DEDHAM STREET CANTON, MA 020211418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $40K | $13K | $52K | 6.56% |
| DBR GROUP3 Filed as: DBR GROUP INC | 959 CONCORD STREET, SUITE 220 FRAMINGHAM, MA 01701 | FALLON HEALTH | $9K | — | $9K | 4.25% |
| KEVIN M HARRINGTON3 Filed as: KEVIN M. HARRINGTON | 770 DEDHAM STREET CANTON, MA 020211418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $485 | $2K | 7.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF MASSACHUSETTES, INC EIN 04-6143185 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $291K |
| CAROL BLANCHARD, D.D.S EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $269K |
| MARK ANTIDORMI EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $186K |
| TINA VALADES EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $181K |
| MARILYN ALTBUSH EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $176K |
| LAURIE MURPHY EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $171K |
| MICHAEL KATZ EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $169K |
| JOANNE C SCHULTZ EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $165K |
| LARRY LIBBY EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $162K |
| ZULLY CRIADO-HEDREEN EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $161K |
| AZITA NEGAHBAN EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $160K |
| ARMAND IEBBA EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $158K |
| EMERALD GREEN BUILDING SERVICE LLC NONE | Direct payment from the plan; Other services Service code 49 | 45 ESSEX ROAD NORWOOD, MA 02062 | $156K |
| ANISSA DERROUCHE EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $154K |
| MANJULA RAMANA EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $149K |
| ELENA JORDACHE EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $143K |
| ANGELIQUE BELISLE EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $135K |
| MARK STANIUL EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $134K |
| DAVID HEFFERNAN EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $132K |
| KATHLEEN GROGAN EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $129K |
| WILLIAM YAMARTINO EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $127K |
| HELEN VRAIBEL EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $127K |
| PATRICIA KOSIOREK EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $127K |
| LAUREN MURPHY EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $126K |
| HELEN REGAN EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $124K |
| MARISSA BIALEK EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $124K |
| ELEANOR PERRY EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $117K |
| LESLIE RUSSELL EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $117K |
| MICHELLE JUTRAS EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $117K |
| JUDITH FERZOCO EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $115K |
| JANET DESSIE EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $113K |
| DIANE RUSSO EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $112K |
| MAUREEN MARTELL EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $106K |
| KEVIN KELLEHER EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $105K |
| ALICE BUCKLEY EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $105K |
| MEDCO HEALTH SOLUTIONS INC EIN 22-3461740 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $105K |
| ROBIN RICE EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $98K |
| INTERCONTINENTAL NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 1270 SOLDIERS FIELD ROAD BOSTON, MA 02135 | $96K |
| LISA BUCHANAN EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $92K |
| KELLY GLYNN EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $92K |
| KELLY MAHONEY EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| JULIE RONDEAU EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| LAURA HORGAN EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| TONI BRANSFIELD EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $89K |
| LOUNA MAHOTIERE EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $89K |
| ALINA MCATEER EIN 04-6374631 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $89K |
| JANICE WHITE EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $89K |
| ANN MARIE JORDAN EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $88K |
| JAMES S. SIDEL, MD NONE | Direct payment from the plan; Consulting (general); Other services Service code 16 | 4 FALMOUTH RD WELLESLEY, MA 02481 | $88K |
| JENNIFER RICCIARELLI EIN 04-6374631 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $88K |
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 | 6,466 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,139 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 7,605 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASS. | 15,820 | $90.2M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 4,711 | $800K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 60 | $21K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 4,711 | $800K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 15,820 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.