| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $34K | $6K | $40K | 2.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | MONY LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 11.05% |
| INDIGO INSURANCE SERVICES3 | UNKNOWN WORCESTER, MA 01608 | MONY LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 7.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $568 | $0 | $568 | 3.87% |
| ACCESS ENROLL3 | 153 CORDAVILLE ROAD, SUITE 130 SOUTHBORO, MA 01772 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $329 | $0 | $329 | 2.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $43 | $43 | 0.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | EYEMED | $415 | $0 | $415 | 9.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $732 | $0 | $732 | 16.74% |
| ACCESS ENROLL3 | 153 CORDAVILLE ROAD, SUITE 130 SOUTHBORO, MA 01772 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $276 | $0 | $276 | 6.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $63 | $63 | 1.44% |
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 | 129 | 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) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 180 | $1.4M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 180 | $1.4M |
| Vision | EYEMED | 77 | $5K |
| Life insurance(2 contracts, 2 carriers) | MONY LIFE INSURANCE COMPANY OF AMERICA | 129 | $44K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 32 | $15K |
| Long-term disability | MONY LIFE INSURANCE COMPANY OF AMERICA | 129 | $40K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 180 | $1.4M |
| Other(2 contracts, 2 carriers) | MONY LIFE INSURANCE COMPANY OF AMERICA | 129 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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.