| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $23K | — | $23K | 1.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $18K | $2K | $20K | 1.16% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD. KING OF PRUSSIA, OH 19406 | HARTFORD LIFE AND ACCIDENT | $4K | $854 | $5K | 7.39% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 100 FRONT STREET, FL 20 WORSESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $4K | $4K | 6.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 9855 SCRANTON ROAD, SUITE 100 SAN DIEGO, CA 92121 | HARTFORD LIFE AND ACCIDENT | $2K | $452 | $2K | 3.41% |
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 | 68 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 83 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 98 | $1.8M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 98 | $1.8M |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 98 | $1.8M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 65 | $69K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 65 | $69K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 65 | $69K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 98 | $1.8M |
| Other | HARTFORD LIFE AND ACCIDENT | 65 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 98 | — |
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.