| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS INSURANCE3 | 1100 ELM STREET MANCHESTER, NH 03101 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $43K | $12K | $55K | 1.22% |
| ERIC BERTZ3 | UNKNOWN AUBURN, MA 01501 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $43K | — | $43K | 0.96% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE WAKEFIELD | 401 EDGEWATER DRIVE, SUITE 220 WAKEFIELD, MA 01880 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $17K | $0 | $17K | 7.50% |
| ERIC BERTZ3 | 175 FEDERAL STREET, SUITE 1050 BOSTON, MA 02110 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $17K | $0 | $17K | 7.50% |
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 | 386 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 401 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 643 | $4.5M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 643 | $4.5M |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 643 | $4.5M |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 388 | $232K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 388 | $232K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 388 | $232K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 388 | $232K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 643 | — |
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.