| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET BRAINTREE, MA 02184 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $80K | — | $80K | 46.16% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET SUITE 400 BRAINTREE, MA 02184 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $6K | — | $6K | 9.98% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET BRAINTREE, MA 02184 | GUARDIAN | $9K | $6K | $15K | 28.87% |
| DAILY FEATS INC3 | 131 TREMONT ST 3RD FLOOR BOSTON, MA 02111 | GUARDIAN | $2K | — | $2K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 SERVICE PROVIDER | Other services; Float revenue; Insurance agents and brokers; Contract Administrator; Other commissions; Claims processing; Insurance brokerage commissions and fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $233K |
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 | 347 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 374 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 511 | $173K |
| Dental | GUARDIAN | 297 | $53K |
| Vision | GUARDIAN | 297 | $53K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 318 | $60K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 318 | $60K |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 511 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 511 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.