| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS | 144 TURNPIKE ROAD SOUTHBOROUGH, MA 01772 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $90K | — | $90K | 10.00% |
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS | 144 TURNPIKE ROAD SOUTHBOROUGH, MA 01772 | THE LINCOLN NATIONAL LIFE INSURANCE COMPNAY | $39K | — | $39K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1900 CROWN COLONY DRIVE STE QUINCY, MA 02169 | VISION SERVICE PLAN | $10K | — | $10K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | ACE AMERICAN INSURANCE COMPNAY | $3K | — | $3K | 19.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $630K |
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 | 4,023 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 4,023 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 6,050 | $1.4M |
| Dental(8 contracts, 3 carriers) | DELTA DENTAL OF RHODE ISALND | 4,023 | $1.2M |
| Vision | VISION SERVICE PLAN | 1,533 | $196K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 3,947 | $899K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPNAY | 3,515 | $386K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 5,644 | $912K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,050 | — |
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.