| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 101 HUNTINGTON AVENUE, SUITE 401 BOSTON, MA 02199 | HARVARD PILGRIM HEALTH CARE | $62K | $20K | $81K | 2.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOSTONIAN GROUP INSURANCE AGENCY | 100 FRONT STREET WORCESTER, MA 01608 | HARVARD PILGRIM HEALTH CARE | $19K | $0 | $19K | 0.54% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 250 PEHLE AVENUE, SUITE 400 PARK 80 WEST, PLAZA 2 SADDLE BROOK, NJ 07663 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $1K | $12K | 8.67% |
| MCO PARTNERS LLC3 Filed as: MCO PARTNERS, LLC | 315 WEST 39TH STREET, SUITE 303 NEW YORK, NY 10018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $2K | $8K | 11.84% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 250 PEHLE AVENUE, SUITE 400 PARK 80 WEST, PLAZA 2 SADDLE BROOK, NJ 07663 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $506 | $6K | 9.32% |
| PAMELA SUSAN LEVY3 | 150 50TH AVENUE LONG ISLAND CITY, NY 11101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $307 | $48 | $355 | 0.56% |
| DRUSILLA ROBERTSON3 | 678 WARBURTON AVENUE, APARTMENT 7C YONKERS, NY 10701 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $201 | $22 | $223 | 0.35% |
| JENNIFER E LUBELSKY3 Filed as: JENNIFER E. LUBELSKY & OTHER AGENTS | 80 JOHN STREET, APARTMENT 11C NEW YORK, NY 10038 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $211 | $2 | $213 | 0.33% |
| SOTERIA PARTNERS LLC3 Filed as: SOTERIA PARTNERS, LLC | 1050 WALL STREET WEST, SUITE 645 LYNDHURST, NJ 07071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $172 | $0 | $172 | 0.27% |
| MICHELLE DARTEE3 | PO BOX 274 SPARTA, NJ 07871 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $34 | $0 | $34 | 0.05% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 250 PEHLE AVENUE, SUITE 400 PARK 80 WEST, PLAZA 2 SADDLE BROOK, NJ 07663 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $2K | $0 | $2K | 10.00% |
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 | 259 | 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) | 259 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 421 | $3.4M |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 390 | $23K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 348 | $140K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 348 | $204K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 348 | $140K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 348 | $204K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 421 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.