| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | UNKNOWN AMHERST, MA 01002 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $22K | $0 | $22K | 2.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA. | $3K | $0 | $3K | 4.29% |
| USI INSURANCE SERVICES LLC3 | 3 LEAR JET LANE, SUITE 104 LATHAM, NY 12110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $458 | $2K | 15.75% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN AMHERST, MA 01002 | ESI EMPLOYEE ASSISTANCE GROUP | $174 | $0 | $174 | 5.00% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 120 | $1.0M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA. | 144 | $64K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 98 | $16K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 98 | $16K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 120 | $1.0M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 112 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.