| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET BRAINTREE, MA 02184 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $28K | $8K | $35K | 2.91% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 931 JEFFERSON BLVD SUITE 3001 WARWICK, RI 02886 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $1K | — | $1K | 0.12% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET SUITE 400 BRAINTREE, MA 02184 | ALTUS DENTAL INSURANCE COMPANY, INC. | $4K | — | $4K | 5.48% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 931 JEFFERSON BLVD SUITE 3001 WARWICK, RI 02886 | ALTUS DENTAL INSURANCE COMPANY, INC. | $380 | — | $380 | 0.50% |
| BAYSTATE BENEFIT SERVICES3 Filed as: BAYSTATE BENEFIT SERVICES, INC | 400 WASHINGTON STREET SUITE 400 BRAINTREE, MA 02184 | SYMETRA LIFE INSURANCE COMPANY | $8K | $740 | $8K | 13.86% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 446 MAIN STREET 5TH FLOOR WORCESTER, MA 01608 | SYMETRA LIFE INSURANCE COMPANY | $3K | — | $3K | 4.52% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET SUITE 400 BRAINTREE, MA 02184 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED) | $327 | — | $327 | 9.89% |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 189 | $1.2M |
| Dental | ALTUS DENTAL INSURANCE COMPANY, INC. | 181 | $75K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED) | 54 | $3K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 130 | $61K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 130 | $61K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 130 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 189 | — |
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.