| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EASTERN BENEFITS GROUP3 | 233 WEST CENTRAL STREET NATICK, MA 01760 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $36K | $9K | $45K | 2.48% |
| EASTERN BENEFIT GROUP3 | PO BOX 4000 WAKEFIELD, MA 01880 | DELTA DENTAL OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $5K | $0 | $5K | 3.83% |
| EASTERN BENEFITS GROUP3 | 233 WEST CENTRAL STREET NATICK, MA 01760 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $3K | $10K | 14.64% |
| STEPHEN SNOW3 Filed as: STEPHEN P. SNOW | 153 CORDAVILLE ROAD SOUTHBOROUGH, MA 01772 | AFLAC | $6K | $867 | $7K | 19.12% |
| DANIEL P CLARK3 Filed as: DANIEL P. CLARK | 33 LANDAU ROAD PLAINVILLE, MA 02762 | AFLAC | $485 | $81 | $566 | 1.60% |
| MJ INSURANCE3 Filed as: ELIZABETH LAWSON AND VARIOUS AGENTS | 7450 HOLLY HILL DRIVE APARTMENT 111 DALLAS, TX 75231 | AFLAC | $230 | $0 | $230 | 0.65% |
| MAUREEN E SNOW3 Filed as: MAUREEN E. SNOW | 68 WINGATE ROAD HOLLISTON, MA 01746 | AFLAC | $209 | $0 | $209 | 0.59% |
| THOMAS E ACKERMAN II3 Filed as: THOMAS E. ACKERMAN II | 30 WHEELER ROAD RUTLAND, MA 01543 | AFLAC | $107 | $0 | $107 | 0.30% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: DAVID S. GRONDIN | 153 CORDAVILLE ROAD, SUITE 120 SOUTHBOROUGH, MA 01772 | AFLAC | $100 | $0 | $100 | 0.28% |
| EASTERN BENEFITS GROUP3 | 650 BROADWAY, SUITE 30 SAUGUS, MA 01906 | AFLAC | $92 | $0 | $92 | 0.26% |
| EASTERN BENEFITS GROUP3 | PO BOX 4000 WAKEFIELD, MA 01880 | EYEMED | $1K | $0 | $1K | 9.97% |
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 | 177 | 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) | 177 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 271 | $1.8M |
| Dental | DELTA DENTAL OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 278 | $122K |
| Vision | EYEMED | 198 | $14K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $70K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $70K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 271 | $1.8M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 278 | — |
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.