| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS, INC. | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $22K | $5K | $27K | 2.91% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $7K | — | $7K | 0.73% |
| EBS INSURANCE BROKERS3 | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $736 | $5K | 8.36% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $887 | $4K | 5.73% |
| EBS INSURANCE BROKERS3 | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $635 | $32 | $667 | 11.46% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $239 | $32 | $271 | 4.66% |
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 | 127 | 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) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 160 | $923K |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 160 | $923K |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 160 | $923K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 127 | $70K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 127 | $64K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 127 | $64K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 160 | $923K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 127 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.