| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS INSURANCE3 | 401 EDGEWATER PLACE WAKEFIELD, MA 01880 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $57K | $39K | $96K | 3.45% |
| CROSS INSURANCE3 | 491 MAIN STREET BANGORE, ME 04401 | PRINCIPAL LIFE INSURANCE COMPANY | $14K | $0 | $14K | 6.38% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE AUGUSTA, ME 04334 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 1.74% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE, SUITE 2 AUGUSTA, ME 04330 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $0 | $10K | 9.59% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN., INC. | 101 SOUTH GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $399 | $8K | $8K | 7.91% |
| JOE FERNANDEZ3 | 7500 DALLAS PARKWAY, SUITE 550 PLANO, TX 75024 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $372 | $372 | 0.37% |
| CROSS INSURANCE3 | 401 EDGEWATER PLACE WAKEFIELD, MA 01880 | STARMOUNT LIFE INSURANCE COMPANY | $3K | $0 | $3K | 12.93% |
| CROSS INSURANCE3 | 491 MAIN STREET BANGORE, ME 04401 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $885 | $885 | 4.31% |
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 | 986 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 991 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 411 | $2.8M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 1,135 | $218K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 278 | $21K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 1,135 | $218K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 170 | $101K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 170 | $101K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 411 | $2.8M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 170 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,135 | — |
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.