| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BP BENEFITS, LLC3 | 160 GOULD STREET, STE 310 NEEDHAM, MA 02494 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $43K | $16K | $59K | 3.52% |
| BP BENEFITS, LLC3 Filed as: BP BENEFITS,LLC | 160 GOULD STREET, STE 310 NEEDHAM, MA 02494 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $6K | — | $6K | 3.44% |
| DOUGLAS S HALL3 | 118 GREENACRE ROAD WESTWOOD, MA 02050 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 5.11% |
| ZVI SHTIFTER3 | 81 CYNTHIA ROAD NEWTON, MA 02459 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 5.03% |
| MICHAEL D HERTZ3 | 34 CYNTHIA ROAD NEEDHAM, MA 02494 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | -$72 | — | -$72 | -0.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TASC EIN 39-1561025 NONE | Contract Administrator Service code 13 | 2302 INTERNATIONAL LANE MADISON, WI 53704 | $4K |
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 | 188 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 401 | $1.7M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 405 | $171K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $93K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $93K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $93K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $93K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 405 | — |
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.