| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SAFETY NET BENEFITS INC3 | 641 SE NORSEMEN DR PORT ST LUCIE, FL 34984 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | $40 | $10K | 8.35% |
| ENROLLMENT SOLUTIONS LTD3 | 65 BURBANK RD SUTTON, MA 01590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $326 | $2K | 1.43% |
| FLEURY ENTERPRISES INC3 | 162 INDIAN POINT RD TIVERTON, RI 02878 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $288 | — | $288 | 0.23% |
| MACQUEEN & ASSOCIATES LLC3 Filed as: MACQUEEN & ASSOCAITES LLC | 415 S WEST ST SUITE 350 ROYAL OAK, MI 48067 | THE UNION LABOR LIFE INSURANCE COMPANY | $6K | $0 | $6K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WARD, FISHER & CO. EIN 05-0234540 NONE | Accounting (including auditing) Service code 10 | — | $98K |
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Plan Administrator Service code 14 | — | $54K |
| RODIO & URSILLO EIN 05-0398359 NONE | Legal Service code 29 | — | $33K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Investment management Service code 28 | — | $30K |
| CHEIRON EIN 13-4215617 NONE | Actuarial Service code 11 | — | $15K |
| ROBERT M. CHEVERIE & ASSOC., P.C. EIN 06-1335139 NONE | Legal Service code 29 | — | $10K |
| BANK OF AMERICA EIN 94-1677665 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $500 |
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 | 595 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 376 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 971 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 1,920 | $10.9M |
| Dental(2 contracts, 2 carriers) | THE UNION LABOR LIFE INSURANCE COMPANY | 1,718 | $115K |
| Vision | HM LIFE INSURANCE COMPANY | 1,510 | $82K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 902 | $33K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 949 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,920 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.