| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GOSS & MCLAIN INSURANCE3 | 1767 NORTHAMPTON STREET HOLYOKE, MA 01040 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 2.62% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 101 HUNTINGTON AVE SUITE 401 BOSTON, MA 23230 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $417 | — | $417 | 0.19% |
| GOSS & MCLAIN INSURANCE3 | 1767 NORTHAMPTON STREET HOLYOKE, MA 01040 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 4.24% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 101 HUNTINGTON AVE SUITE 401 BOSTON, MA 02199 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $223 | — | $223 | 0.26% |
| GOSS & MCLAIN INSURANCE3 | 1767 NORTHAMPTON STREET HOLYOKE, MA 01040 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.76% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 101 HUNTINGTON AVE SUITE 401 BOSTON, MA 02199 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $400 | — | $400 | 3.04% |
| GOSS & MCLAIN INSURANCE3 | 1767 NORTHAMPTON STREET HOLYOKE, MA 01040 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $405 | — | $405 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH NEW ENGLAND EIN 04-3012347 NONE | Claims processing Service code 12 | — | $430K |
| NEW ENGLAND DENTAL ADMINISTRATORS EIN 04-3351309 NONE | Claims processing Service code 12 | — | $47K |
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 | 1,397 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,408 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 895 | $86K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 978 | $221K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,397 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,397 | — |
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."
No prospect flags tripped on this filing.