| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $44K | $0 | $44K | 2.16% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | UNKNOWN EMMERYVILLE, CA 94608 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $0 | $17K | $17K | 0.82% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 5448 THORNWOOD DRIVE SAN JOSE, CA 95120 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 1.08% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | DELTA DENTAL OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | $5K | $0 | $5K | 3.58% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | VISION SERVICE PLAN | $822 | $0 | $822 | 6.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER RISK MANAGEMENT SERVICES | TWO PIERCE PLACE ITASCA, IL 60143 | FEDERAL INSURANCE COMPANY | $1K | $0 | $1K | 20.00% |
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 | 408 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 416 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 881 | $2.0M |
| Dental | DELTA DENTAL OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | 890 | $146K |
| Vision | VISION SERVICE PLAN | 348 | $12K |
| Life insurance | STANDARD INSURANCE COMPANY | 383 | $224K |
| Short-term disability | STANDARD INSURANCE COMPANY | 383 | $224K |
| Long-term disability | STANDARD INSURANCE COMPANY | 383 | $224K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 881 | $2.0M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 408 | $230K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 890 | — |
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.