| 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. | $74K | $44K | $118K | 2.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | $849 | $21K | 15.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | VISION SERVICE PLAN | $1K | $0 | $1K | 3.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE, 10TH FLOOR BOSTON, MA 02116 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $496 | $3K | 13.58% |
| M. FINANCIAL HOLDINGS INCORPORATED3 | 1125 COUCH STREET, SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $506 | $34 | $540 | 2.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $23 | $0 | $23 | 0.09% |
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 | 440 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 445 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 756 | $3.9M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 756 | $3.9M |
| Vision | VISION SERVICE PLAN | 344 | $34K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 440 | $132K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 440 | $132K |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 440 | $157K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 756 | $3.9M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 440 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 756 | — |
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.