| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $5K | — | $5K | 3.70% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $28K | $6K | $34K | 25.51% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $2K | — | $2K | 37.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HILB GROUP OF NEW ENGLAND EIN 47-4324398 PRODUCER | Contract Administrator; Insurance agents and brokers; Claims processing Service code 12 | — | $100K |
| ULTRABENEFITS INC. EIN 04-3525752 BENEFITS ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $42K |
| CIGNA EIN 59-1031071 NETWORK | Claims processing; Contract Administrator Service code 12 | — | $25K |
| ACCOLADE EIN 01-0969591 CONCIERGE | Claims processing; Contract Administrator Service code 12 | — | $4K |
| RIGHTWAY EIN 82-0865206 CONCIERGE | Claims processing; Contract Administrator Service code 12 | — | $3K |
| TELEDOC NETWORK | Contract Administrator; Other fees; Claims processing Service code 12 | 2 MANHATTANVILLE RD. PURCHASE, NY 10577 | $3K |
| PHIA GROUP EIN 04-3504115 FIDUCIARY | Named fiduciary; Contract Administrator; Claims processing Service code 12 | — | $2K |
| ZELIS EIN 86-1040704 CLAIMS REVIEW | Claims processing; Contract Administrator Service code 12 | — | $1K |
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 | 152 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 294 | $136K |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 216 | $5K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $134K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $134K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $134K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE LIFE INSURANCE COMPANY | 131 | $523K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $134K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 294 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.