| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 | — | HARVARD PILGRIM HEALTH CARE | $29K | — | $29K | 1.31% |
| MICHAEL P TSOTSIS3 | — | HARVARD PILGRIM HEALTH CARE | $6K | — | $6K | 0.27% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | DELTA DENTAL OF MASSACHUSETTS | $8K | — | $8K | 2.59% |
| RSC INSURANCE BROKERAGE INC3 | — | HARVARD PILGRIM HEALTH CARE | $3K | — | $3K | 1.31% |
| MICHAEL P TSOTSIS3 | — | HARVARD PILGRIM HEALTH CARE | $666 | — | $666 | 0.27% |
| RSC INSURANCE BROKERAGE INC3 | 333 WEST WACKER DRIVE SUITE 1950 CHICAGO, IL 60606 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $18K | $6K | $24K | 23.06% |
| RSC INSURANCE BROKERAGE INC3 | — | HARVARD PILGRIM HEALTH CARE | $1K | — | $1K | 1.37% |
| MICHAEL P TSOTSIS3 | — | HARVARD PILGRIM HEALTH CARE | $263 | — | $263 | 0.28% |
| MARK BAKER3 | 54 DANBURY RD, #340 RIDGEFIELD, CT 06877 | GENWORTH LIFE INSURANCE COMPANY | $13K | — | $13K | 13.39% |
| RSC INSURANCE BROKERAGE INC3 | — | HARVARD PILGRIM HEALTH CARE | $586 | — | $586 | 1.31% |
| MICHAEL P TSOTSIS3 | — | HARVARD PILGRIM HEALTH CARE | $120 | — | $120 | 0.27% |
| RSC INSURANCE BROKERAGE INC3 | — | HARVARD PILGRIM HEALTH CARE | $210 | — | $210 | 1.02% |
| MICHAEL P TSOTSIS3 | — | HARVARD PILGRIM HEALTH CARE | $43 | — | $43 | 0.21% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET FLOOR 2 BOSTON, MA 02110 | VISION SERVICE PLAN | $870 | — | $870 | 5.98% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET FLOOR 2 BOSTON, MA 02110 | VISION SERVICE PLAN | $42 | — | $42 | 0.29% |
| RSC INSURANCE BROKERAGE INC3 | — | HARVARD PILGRIM HEALTH CARE | $88 | — | $88 | 0.79% |
| MICHAEL P TSOTSIS3 | — | HARVARD PILGRIM HEALTH CARE | $18 | — | $18 | 0.16% |
| MARK BAKER3 | 54 DANBURY ROAD #340 RIDGEFIELD, CT 06877 | GENWORTH LIFE INSURANCE COMPANY | $1K | — | $1K | 14.99% |
| RSC INSURANCE BROKERAGE INC3 | — | HARVARD PILGRIM HEALTH CARE | $40 | — | $40 | 1.30% |
| MICHAEL P TSOTSIS3 | — | HARVARD PILGRIM HEALTH CARE | $8 | — | $8 | 0.26% |
| MICHAEL P TSOTSIS3 Filed as: MICHAEL TSOTSIS | 446 MAIN STREET WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | $113 | — | $113 | 15.07% |
No Schedule C service providers reported on this filing.
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 | 322 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 400 | $4.2M |
| Dental | DELTA DENTAL OF MASSACHUSETTS | 635 | $292K |
| Vision | VISION SERVICE PLAN | 91 | $15K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 323 | $105K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 323 | $105K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 323 | $105K |
| Other(4 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 542 | $207K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 635 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.