| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | 333 ELM STREET 3RD FLOOR DEDHAM, MA 02026 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | $15K | $4K | $20K | 2.80% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | 333 ELM STREET #300 DEDHAM, MA 02026 | TUFTS INSURANCE COMPANY | $5K | $1K | $6K | 1.99% |
| FIAI INC3 Filed as: FIAI, INC. | P.O. BOX 1388 BANGOR, ME 04402 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL | $4K | — | $4K | 1.87% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | 333 ELM STREET 3RD FLOOR NORFOLK, MA 02056 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL | $10 | — | $10 | 0.01% |
| POOLE PROFESSIONAL LTD3 Filed as: POOLE PROFESSIONAL LTD INSURANCE AG | 107 AUDUBON ROAD WAKEFIELD, MA 01880 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL | $5 | — | $5 | 0.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | 333 ELM STREET #300 DEDHAM, MA 02026 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 9.93% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | 333 ELM STREET #300 DEDHAM, MA 02026 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 13.84% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | 333 ELM STREET #300 DEDHAM, MA 02026 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 9.22% |
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 | 144 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | 150 | $1.0M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL | 377 | $188K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 65 | $17K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 65 | $23K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 65 | $20K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 65 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 377 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.