| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 115 FEDERAL STREET BOSTON, MA 02110 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $95K | $48K | $144K | 2.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $53K | $18K | $71K | 24.28% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES, LLC | 100 FRONT STREET, 20TH FLOOR WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | $0 | $20K | $20K | 7.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE, 10TH FLOOR BOSTON, MA 02116 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 4.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $326 | $3K | 8.96% |
| M. FINANCIAL HOLDINGS INCORPORATED3 Filed as: M FINANCIAL HOLDINGS INCORPORATED | 1125 COUCH STREET, SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $475 | $20 | $495 | 1.36% |
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 | 667 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 31 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 698 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 876 | $6.1M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 876 | $6.1M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 729 | $45K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 667 | $293K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 667 | $293K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 667 | $329K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 876 | $6.1M |
| Other | HARTFORD LIFE AND ACCIDENT | 667 | $293K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 876 | — |
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.