| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK F BAILEY3 | 1200 PLANTATION ISLAND DR S STE 210 SAINT AUGUSTINE, FL 28965 | UNITED HEALTHCARE INSURANCE COMPANY | $17K | — | $17K | 1.61% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 2000 CHAPEL VIEW BLVD STE 240 CRANSTON, RI 00131 | UNITED HEALTHCARE INSURANCE COMPANY | $12K | — | $12K | 1.16% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DR # 210 ST AUGUSTINE, FL 32080 | UNITED HEALTHCARE INSURANCE COMPANY | — | $7K | $7K | 0.66% |
| KENNETH S BETTENHAUSER3 | 15 BERKSHIRE RD STE B MANSFIELD, MA 00913 | UNITED HEALTHCARE INSURANCE COMPANY | $6K | — | $6K | 0.54% |
| MARK BAILEY3 | 309 REDWING LANE ST AUGUSTINE, FL 32080 | GUARDIAN | $3K | — | $3K | 21.32% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND | PO BOX 622 MANSFIELD, MA 02048 | GUARDIAN | $3K | $270 | $3K | 21.07% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF NEW ENGLAND LLC | 2000 CHAPEL VIEW BLVD STE 240 CRANSTON, RI 02920 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $614 | — | $614 | 5.18% |
| STEVEN R KARAS3 | 2000 COMMONWEALTH AVE STE 305 AUBURNDALE, MA 01890 | AFLAC | $382 | — | $382 | 18.88% |
| DAVID S HALLETT3 | 8 BROOKS ST WINCHESTER, MA 01890 | AFLAC | $77 | — | $77 | 3.81% |
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 | 306 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 311 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 315 | $1.1M |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 315 | $1.1M |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 152 | $12K |
| Short-term disability | GUARDIAN | 306 | $14K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 315 | $1.1M |
| Other | AFLAC | 2 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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.