| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $10K | — | $10K | 2.59% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 4.35% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $3K | $9K | 17.94% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | VISION SERVICE PLAN | $2K | — | $2K | 3.72% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 5.88% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 154.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE BENEFIT ADMIN. OF MASS. MEDICAL CLAIMS ADMIN | Claims processing; Contract Administrator; Other services; Participant communication Service code 12 | P.O. BOX 55917 BOSTON, MA 022055917 | $399K |
| UNITED OF OMAHA LIFE INSURANCE CO STD THIRD PARTY ADMIN | Contract Administrator; Claims processing Service code 12 | 3300 MUTUAL OF OMAHA PLZ. OMAHA, NE 68175 | $15K |
| HILB GROUP OF NEW ENGLAND BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | $14K |
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 | 633 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 52 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 685 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 1,000 | $390K |
| Vision | VISION SERVICE PLAN | 453 | $51K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 633 | $128K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $2K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 633 | $50K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 633 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,000 | — |
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."
No prospect flags tripped on this filing.