| 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. | $36K | $8K | $45K | 2.75% |
| INDIGO INSURANCE SERVICES3 | UNKNOWN WORCESTER, MA 01608 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 6.49% |
| ACCESS ENROLL3 | 153 CORDAVILLE ROAD, SUITE 130 SOUTHBORO, MA 01772 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $728 | $18 | $746 | 6.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $711 | — | $711 | 5.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $79 | $79 | 0.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 16.92% |
| ACCESS ENROLL3 | 153 CORDAVILLE ROAD, SUITE 130 SOUTHBORO, MA 01772 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $467 | $5 | $472 | 7.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $87 | $87 | 1.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | EYEMED | $509 | — | $509 | 12.63% |
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 | 165 | 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) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 196 | $1.6M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 196 | $1.6M |
| Vision | EYEMED | 109 | $4K |
| Life insurance(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 165 | $53K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 39 | $12K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 165 | $47K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 196 | $1.6M |
| Other(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 165 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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.