| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOSTON INSURANCE EMPLOYEE BENEFITS3 Filed as: BOSTON INS EMPLOYEE BENEFITS TRUST | 18 RESEARCH PKWY STE 1600 WALLINGFORD, CT 06492 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 6.00% |
| CLARK INSURANCE3 Filed as: CLARK AGENCY LLC | 180 GLASTONBURY BLVD GLASTONBURY, CT 06033 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 3.63% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | METROPOLITAN LIFE INSURANCE COMPANY | $112 | $48 | $160 | 0.21% |
| CLARK INSURANCE3 Filed as: CLARK AGENCY LLC | 180 GLASTONBURY BLVD GLASTONBURY, CT 06033 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 5.71% |
| PROFESSIONAL PENSIONS INC3 | 10 RESEARCH PKWY WALLINGFORD, CT 06492 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 4.56% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES INC. | 1250 CAPITAL OF TX HWY BLDG 2 STE 125 AUSTIN, TX 78746 | STANDARD INSURANCE COMPANY | $629 | — | $629 | 1.67% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DRIVE SUITE 600 SAN MATEO, CA 94404 | STANDARD INSURANCE COMPANY | $264 | — | $264 | 0.70% |
| CLARK INSURANCE3 Filed as: CLARK AGENCY LLC | 180 GLASTONBURY BLVD GLASTONBURY, CT 06033 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 10.64% |
| PROFESSIONAL PENSIONS INC3 | 10 RESEARCH PKWY WALLINGFORD, CT 06492 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 4.57% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DRIVE SUITE 600 SAN MATEO, CA 94404 | STANDARD INSURANCE COMPANY | $401 | — | $401 | 1.73% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TX HWY BLDG 2 STE 125 AUSTIN, TX 78746 | STANDARD INSURANCE COMPANY | $378 | — | $378 | 1.63% |
| CLARK INSURANCE3 Filed as: CLARK AGENCY LLC | 180 GLASTONBURY BLVD GLASTONBURY, CT 06033 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 8.19% |
| PROFESSIONAL PENSIONS INC3 | 10 RESEARCH PKWY WALLINGFORD, CT 06492 | STANDARD INSURANCE COMPANY | $578 | — | $578 | 4.62% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TX HWY BLDG 2 STE 125 AUSTIN, TX 78746 | STANDARD INSURANCE COMPANY | $224 | — | $224 | 1.79% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DRIVE SUITE 600 SAN MATEO, CA 94404 | STANDARD INSURANCE COMPANY | $183 | — | $183 | 1.46% |
| CLARK INSURANCE3 Filed as: CLARK AGENCY LLC | 180 GLASTONBURY BLVD GLASTONBURY, CT 06033 | VISION SERVICE PLAN | $565 | — | $565 | 7.77% |
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 | 100 | 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) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QBE INSURANCE | 94 | $547K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 160 | $78K |
| Vision | VISION SERVICE PLAN | 53 | $7K |
| Life insurance | STANDARD INSURANCE COMPANY | 117 | $13K |
| Short-term disability | STANDARD INSURANCE COMPANY | 108 | $38K |
| Long-term disability | STANDARD INSURANCE COMPANY | 108 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.