| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: BORISLOW INSURANCE AGENCY, INC. | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $45K | $11K | $56K | 2.39% |
| ASSUREDPARTNERS3 Filed as: BORISLOW INSURANCE AGENCY, INC. | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $17K | $4K | $21K | 13.44% |
| ASSUREDPARTNERS3 Filed as: BORISLOW INSURANCE AGENCY, INC. | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $378 | $7 | $385 | 3.92% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 100 FRONT STREET SUITE 800 WORCESTER, MA 01608 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $76 | $0 | $76 | 0.77% |
| ASSUREDPARTNERS3 Filed as: BORISLOW INSURANCE AGENCY, INC. | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | EYEMED VISION CARE | $379 | $0 | $379 | 9.06% |
| ASSUREDPARTNERS3 Filed as: BORISLOW INSURANCE AGENCY, INC. | ONE GRIFFIN BROOK DRVIE METHUEN, MA 01844 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $223 | $8 | $231 | 8.63% |
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 | 415 | 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) | 420 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 521 | $2.4M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 521 | $2.4M |
| Vision | EYEMED VISION CARE | 66 | $4K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 415 | $158K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 415 | $158K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 415 | $158K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 521 | $2.4M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 415 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 521 | — |
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.