| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE BOSTON, MA 02116 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $69K | $29K | $98K | 1.96% |
| INDIGO INSURANCE SERVICES3 | 446 MAIN STREET, 5TH FLOOR WORCESTER, MA 01608 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $11K | — | $11K | 7.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2245 TEXAS DRIVE #140 SUGARLAND, TX 77479 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $10K | — | $10K | 6.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE, 10TH FLOOR BOSTON, MA 02116 | EYEMED VISION CARE | $4K | — | $4K | 10.59% |
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 | 367 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 370 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 860 | $5.0M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 860 | $5.0M |
| Vision | EYEMED VISION CARE | 634 | $40K |
| Life insurance | AMERICAN GENERAL LIFE INSURANCE COMPANY | 465 | $159K |
| Long-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 465 | $159K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 860 | $5.0M |
| Other(2 contracts, 2 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 465 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 860 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.