| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBS INSURANCE BROKERS3 | 1 GATEWAY CENTER STE 650 NEWTON, MA 02458 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | $70K | $24K | $95K | 2.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MASSACHUSETTS | THREE COPLEY PLACE STE 300 BOSTON, MA 02116 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | $72K | — | $72K | 1.53% |
| EBS INSURANCE BROKERS3 | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | DELTA DENTAL OF MASSACHUSETTS | $8K | — | $8K | 1.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MASSACHUSETTS | PO BOX 416672 BOSTON, MA 02241 | DELTA DENTAL OF MASSACHUSETTS | $5K | — | $5K | 1.11% |
| EBS INSURANCE BROKERS3 | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | KAISER FOUNDATION HEALTH PLAN INC | $21K | $4K | $25K | 6.05% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN INC | $4K | $800 | $5K | 1.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MASSACHUSETTS | THREE COPLEY PLACE STE 300 BOSTON, MA 02116 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $2K | $5K | 2.63% |
| EBS INSURANCE BROKERS3 | ONE GATEWAY CENTER SUITE 650 NEWTON, MA 02458 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 2.27% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS, INC | ONE GATEWAY CENTER SUITE 650 NEWTON, MA 02458 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 3.31% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MASSACHUSETTS | THREE COPLEY PLACE STE 300 BOSTON, MA 02116 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $898 | $2K | 2.90% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS, INC | ONE GATEWAY CENTER SUITE 650 NEWTON, MA 02458 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 5.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MASSACHUSETTS | THREE COPLEY PLACE STE 300 BOSTON, MA 02116 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $761 | $3K | 3.73% |
| EBS INSURANCE BROKERS3 | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | VISION SERVICE PLAN | $588 | — | $588 | 1.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MASSACHUSETTS | 3 COPLEY PLACE BOSTON, MA 02116 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $878 | — | $878 | 6.74% |
| EBS INSURANCE BROKERS3 | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $815 | — | $815 | 6.26% |
| BULFINCH GROUP INSURANCE AGENCY3 | 160 GOULD ST NEEDHAM, MA 02494 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $34 | — | $34 | 0.26% |
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 | 357 | 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) | 357 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | 816 | $5.1M |
| Dental | DELTA DENTAL OF MASSACHUSETTS | 958 | $453K |
| Vision | VISION SERVICE PLAN | 356 | $40K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 357 | $86K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 357 | $185K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 357 | $85K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 357 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 958 | — |
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.