| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS | 144 TURNPIKE ROAD SOUTHBOROUGH, MA 01772 | MINNESOTA LIFE INSURANCE PLAN | $43K | — | $43K | 1.03% |
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS INC | 144 TURNKPIKE ROAD SOUTHBOROUGH, MA 01772 | MINNESOTA LIFE INSURANCE PLAN | $24K | — | $24K | 1.03% |
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS INC | 144 TURNPIKE ROAD SOUTHBOROUGH, MA 01772 | MINNESOTA LIFE INSURANCE PLAN | $4K | — | $4K | 1.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CONNECTICUT GENERAL LIFE INSURANCE EIN 06-0303370 NONE | Claims processing Service code 12 | — | $853K |
| EXPRESS SCRIPTS NONE | Claims processing Service code 12 | 1 EXPRESS WAY ST. LOUIS, MO 63121 | $565K |
| DELTA DENTAL OF MASSACHUSETTS NONE | Claims processing Service code 12 | 465 MEDFORD STREET BOSTON, MA 021291454 | $29K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8,237 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 8,237 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts) | MINNESOTA LIFE INSURANCE PLAN | 4,750 | $6.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,750 | — |
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.