| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TELAMON HUMAN CAPITAL RESOURCES3 Filed as: TELAMON HUMAN CAPITAL RESOURCES GRO | 30 SOUTHWEST PARK WESTWOOD, MA 02090 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $41K | $6K | $47K | 1.85% |
| CHANDOR INSURANCE AGENCY LLC3 Filed as: CHANDOR INSURANCE AGENCY, LLC | 177 MILK STREET, 3RD FLOOR BOSTON, MA 02109 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $5K | — | $5K | 0.20% |
| TELAMON HUMAN CAPITAL RESOURCES3 Filed as: TELAMON HUMAN CAPITAL RESOURCES GRO | 30 SOUTHWEST PARK WESTWOOD, MA 02090 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 7.02% |
| CHANDOR INSURANCE AGENCY LLC3 Filed as: CHANDOR INSURANCE AGENCY, LLC | 177 MILK STREET, 3RD FLOOR BOSTON, MA 02019 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 1.58% |
| TELAMON HUMAN CAPITAL RESOURCES3 Filed as: TELAMON HUMAN CAPITAL RESOURCES GRO | 30 SOUTHWEST PARK WESTWOOD, MA 02090 | VISION SERVICE PLAN | $843 | — | $843 | 5.46% |
| CHANDOR INSURANCE AGENCY LLC3 Filed as: CHANDOR INSURANCE AGENCY, LLC | 177 MILK STREET, 3RD FLOOR BOSTON, MA 02109 | VISION SERVICE PLAN | $281 | — | $281 | 1.82% |
| TELA HUMAN CAP RESOURCES GROUP LLC0 | 30 SOUTHWEST PARK WESTWOOD, MA 02090 | FOUR EVER LIFE INS CO | $334 | — | $334 | 14.99% |
| INDIGO INSURANCE SERVICES0 | 101 HUNTINGTON AVENUE BOSTON, MA 02199 | FOUR EVER LIFE INS CO | — | $178 | $178 | 7.99% |
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 | 212 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 240 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 395 | $2.5M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 395 | $2.5M |
| Vision | VISION SERVICE PLAN | 152 | $15K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 212 | $129K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 212 | $129K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 212 | $129K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 212 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 395 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.