| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEMAX, INC.3 | 7 WEST MILL STREET MEDFIELD, MA 02052 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $75K | $21K | $96K | 1.69% |
| BENEMAX, INC.3 | 7 WEST MILL STREET MEDFIELD, MA 02052 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $12K | — | $12K | 2.59% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INS SERVICES LLC | 446 MAIN ST. 5TH FLOOR WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | $0 | $24K | $24K | 7.00% |
| BENEMAX, INC.3 | 7 WEST MILL STREET MEDFIELD, MA 02052 | HARTFORD LIFE AND ACCIDENT | $12K | $894 | $13K | 3.86% |
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 | 330 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 338 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 855 | $5.7M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 879 | $472K |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 855 | $5.7M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 362 | $344K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 362 | $344K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 362 | $344K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 855 | $5.7M |
| Other | HARTFORD LIFE AND ACCIDENT | 362 | $344K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 879 | — |
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.