| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT SOLUTIONS, INC. | 12 KINGSDALE STREET BURLINGTON, MA 01803 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $118K | $0 | $118K | 3.08% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $36K | $0 | $36K | 0.95% |
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT SOLUTIONS, INC. | PO BOX 1023 BURLINGTON, MA 01803 | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | $8K | $0 | $8K | 4.41% |
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT SOLUTIONS, INC. | PO BOX 1023 BURLINGTON, MA 01803 | OXFORD HEALTH PLANS (NY), INC. | $2K | $0 | $2K | 2.49% |
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT SOLUTIONS, INC. | PO BOX 1023 BURLINGTON, MA 01803 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.95% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | PO BOX 736061 CHICAGO, IL 60673 | VISION SERVICE PLAN | $745 | $0 | $745 | 2.99% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 111 SOUTH BEDFORD STREET BURLINGTON, MA 01803 | FIRST UNUM LIFE INSURANCE COMPANY | $447 | $0 | $447 | 2.06% |
| THOMAS CHRISTOPHER SMITH3 Filed as: THOMAS SMITH | 798 BERRY ROAD NASHVILLE, TN 37204 | FIRST UNUM LIFE INSURANCE COMPANY | $120 | $0 | $120 | 0.55% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 111 SOUTH BEDFORD STREET BURLINGTON, MA 01803 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.95% |
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 | 151 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 287 | $3.9M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 287 | $3.8M |
| Vision(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 287 | $3.9M |
| Life insurance | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | 222 | $191K |
| Short-term disability(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 52 | $23K |
| Long-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | 222 | $191K |
| Prescription drug(3 contracts, 3 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 287 | $4.0M |
| Other(3 contracts, 3 carriers) | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | 222 | $217K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.