| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COSTELLO BENEFITS GROUP3 | 800 WEST CUMMINGS PARK, SUITE 4000 WOBURN, MA 01801 | BLUE CROSS AND BLUE SHIELD OF MASSACHUSETTS, INC. | $14K | $10K | $23K | 1.96% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | 160 FEDERAL STREET BOSTON, MA 02110 | BLUE CROSS AND BLUE SHIELD OF MASSACHUSETTS, INC. | $15K | $0 | $15K | 1.28% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | 160 FEDERAL STREET BOSTON, MA 02110 | DELTA DENTAL OF MASSACHUSETTS, INC. | $2K | $0 | $2K | 2.17% |
| COSTELLO BENEFITS GROUP3 | 800 WEST CUMMINGS PARK, SUITE 4000 WOBURN, MA 01801 | DELTA DENTAL OF MASSACHUSETTS, INC. | $2K | $0 | $2K | 1.83% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | 160 FEDERAL STREET BOSTON, MA 02110 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $8 | $6K | 9.83% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 1250 CAPITAL OF TEXAS HIGHWAY SOUTH BUILDING LL, SUITE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $2 | $2 | 0.00% |
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 | 133 | 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) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MASSACHUSETTS, INC. | 254 | $1.2M |
| Dental | DELTA DENTAL OF MASSACHUSETTS, INC. | 249 | $114K |
| Vision | BLUE CROSS AND BLUE SHIELD OF MASSACHUSETTS, INC. | 254 | $1.2M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 112 | $65K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 112 | $65K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 112 | $65K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 112 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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.