| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | HARVARD PILGRIM HEALTH CARE | $159K | $0 | $159K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | HPHC INSURANCE COMPANY | $43K | $0 | $43K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $24K | $3K | $28K | 4.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $37K | $0 | $37K | 10.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC AVENUE, SUITE 300 MOUNT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $4K | $4K | 1.19% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $82 | $82 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.75% |
| INDIGO INSURANCE SERVICES3 | 101 HUNTINGTON AVENUE, SUITE 1300 BOSTON, MA 02199 | FOUR EVER LIFE INSURANCE COMPANY | $650 | $347 | $997 | 23.00% |
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 | 393 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 52 | 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)(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 794 | $6.7M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 999 | $613K |
| Vision | VISION SERVICE PLAN | 308 | $50K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 393 | $367K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 393 | $367K |
| Prescription drug(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 794 | $6.7M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 409 | $383K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 999 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.