| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | — | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $34K | $0 | $34K | 2.01% |
| ELLEN KAPLAN3 | 160 SPEEN STREET FRAMINGHAM, MA 01701 | DELTA DENTAL OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $6K | $0 | $6K | 3.86% |
| ELLEN ANN KAPLAN3 | 160 SPEEN ST STE 101 FRAMINGHAM, MA 01701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $138 | $2K | 10.76% |
| ELLEN ANN KAPLAN3 | 160 SPEEN ST STE 101 FRAMINGHAM, MA 01701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $183 | $2K | 11.19% |
| ELLEN ANN KAPLAN3 | 160 SPEEN ST STE 101 FRAMINGHAM, MA 01701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $109 | $2K | 10.74% |
| ELLAN KAPLAN3 | 160 SPEEN ST FRAMINGHAM, MA 017012003 | VISION SERVICE PLAN | $907 | $0 | $907 | 6.86% |
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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 313 | $1.7M |
| Dental | DELTA DENTAL OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 299 | $146K |
| Vision | VISION SERVICE PLAN | 150 | $13K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $18K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $15K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 64 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 313 | — |
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.