| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LUMITY, INC.3 | 5214F DIAMOND HEIGHTS BOULEVARD UNIT 1152 SAN FRANCISCO, CA 94131 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $32K | $0 | $32K | 1.86% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS, INC. | 1 GATEWAY CENTER, SUITE 650 NEWTON, MA 02458 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $11K | $0 | $11K | 0.63% |
| LUMITY, INC.3 | 5214F DIAMOND HEIGHTS BOULEVARD UNIT 1152 SAN FRANCISCO, CA 94131 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | $0 | $6K | 7.68% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS, INC. | 1 GATEWAY CENTER, SUITE 650 NEWTON, MA 02458 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 3.21% |
| LUMITY, INC.3 | 5214F DIAMOND HEIGHTS BOULEVARD UNIT 1152 SAN FRANCISCO, CA 94131 | VISION SERVICE PLAN | $752 | $0 | $752 | 5.64% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS, INC. | 1 GATEWAY CENTER, SUITE 650 NEWTON, MA 02458 | VISION SERVICE PLAN | $321 | $0 | $321 | 2.41% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN ROAD SUITE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $16 | $0 | $16 | 0.12% |
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 | 106 | 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) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 252 | $1.7M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 252 | $1.7M |
| Vision | VISION SERVICE PLAN | 100 | $13K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 106 | $72K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 106 | $72K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 106 | $72K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 252 | $1.7M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 106 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 252 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.