| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $42K | $42K | 1.54% |
| EASTERN BENEFITS GROUP3 | PO BOX 4000 WAKEFIELD, MA 01880 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $13K | $13K | 0.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $10K | $2K | $12K | 10.39% |
| LYNN FEAZEL3 Filed as: LYNN S. FEAZEL | 150A ANDOVER STREET, SUITE 12C DANVERS, MA 01923 | AFLAC | $2K | $35 | $2K | 8.10% |
| CHRISTOPHER C FEAZEL3 Filed as: CHRISTOPHER C. FEAZEL | 150A ANDOVER STREET, SUITE 12C DANVERS, MA 01923 | AFLAC | $1K | $7 | $1K | 5.90% |
| DAVID S HALLETT3 Filed as: DAVID S. HALLETT | 8 BROOKS STREET WINCHESTER, MA 01890 | AFLAC | $304 | $0 | $304 | 1.22% |
| TIMOTHY F. COLPOYS3 | 48 KITTERY AVENUE, SUITE 2 ROWLEY, MA 01969 | AFLAC | $175 | $0 | $175 | 0.70% |
| RAFAEL DAVID DILONE3 | 11 WADSWORTH STREET DANVERS, MA 01923 | AFLAC | $154 | $0 | $154 | 0.62% |
| MARLENE R. CONROY AND VAROUS AGENTS3 | 2 PARSONS DRIVE SWAMPSCOTT, MA 01907 | AFLAC | $22 | $0 | $22 | 0.09% |
| DAVID VIRDEN3 | 43 BELCHER STREET ESSEX, MA 01929 | AFLAC | $20 | $0 | $20 | 0.08% |
| EASTERN BENEFITS GROUP3 | PO BOX 4000 WAKEFIELD, MA 01880 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. | $375 | $0 | $375 | 6.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. | $183 | $0 | $183 | 3.31% |
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 | 111 | 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) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 144 | $2.7M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 144 | $2.7M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 111 | $120K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 111 | $120K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 111 | $120K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 144 | $2.7M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 111 | $145K |
| 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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.