| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN MA LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $44K | $16K | $60K | 3.74% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 80 SOUTH 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $2K | — | $2K | 2.70% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 80 S 8TH STREET UNIT 700 MINNEAPOLIS, MN 55402 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 13.68% |
| INDIGO INSURANCE SERVICES3 | 101 HUNTINGTON AVE BOSTON, MA 02199 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 7.59% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $701 | — | $701 | 9.99% |
| MCCAREY INC3 | 6320 GREENHAVEN DR CARLSBAD, CA 92009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | — | $65 | 2.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 3310 SANTA BARBARA, CA 93130 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 1.28% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.86% |
| WOOD GUTMANN & BOGART INSURANCE3 Filed as: WOOD GUTMAN & BOGART INSURANCE BRO | 15901 RED HILL AVE TUSTIN, CA 92780 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.48% |
| DEL DOWNEY3 | 32056 MERLOT CRST TEMECULA, CA 92591 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.41% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R &B ENROLLMENT SERVICES INC | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.34% |
| STACIE M. FERRARIS AND OTHER AGENTS3 Filed as: STACIE MARIE FERRARIS | 28912 GLEN ROCK PLACE HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.28% |
| BRUCE W BUSSER3 | 22461 SAN JOAQUIN DRIVE WEST CANYON LAKE, CA 92587 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.21% |
| WANDA MCGINTY3 | 29075 RED TAIL COURT HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.17% |
| LORI LAINE3 | 35837 CARTER ST YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.17% |
| SUSIE A ESTRADA3 | 25742 PARK AVE SAN JUAN CAPISTRANO, CA 92675 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.10% |
| TANA L MAY3 | PO BOX 455 HARRISON, AR 72602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.10% |
| MIKE MCCORMICK3 | 7 MONSERRAT PL FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.07% |
| MARGIE C HART3 | 4179 KINGS PLACE SPRINGDALE, AR 72762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.07% |
| ARIAN E NAWABI3 | 201 DARLINGTON IRVINE, CA 92620 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.07% |
| MELISSA L GEORGE & ASSOCIATES LLC3 Filed as: MELISSA L GEORGE & ASSOCIATES INC | 2905 E POINT STREET EAST POINT, GA 30344 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| INDIGO INSURANCE SERVICES3 | 101 HUNTINGTON AVE ATTENTION RICK CELLA BOSTON, MA 02199 | USABLE LIFE | $387 | — | $387 | 19.99% |
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 | 246 | 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) | 246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 202 | $1.6M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 191 | $87K |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 117 | $7K |
| Life insurance(3 contracts, 3 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 246 | $41K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 17 | $3K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 202 | $1.6M |
| Other(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 246 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 246 | — |
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.