| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $10K | $3K | $13K | 1.69% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES NY LLC | 21ST FLOOR 340 MADISON AVENUE NEW YORK, NY 10173 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $6K | $0 | $6K | 0.74% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES (NY) LLC | 21ST FLOOR 340 MADISON AVENUE NEW YORK, NY 10173 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $26K | $0 | $26K | 6.26% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $53 | $53 | 0.01% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $9 | $9 | 0.00% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES NY LLC | 340 MADISON AVE FL 21 NEW YORK, NY 10173 | VISION SERVICE PLAN | $871 | $0 | $871 | 1.74% |
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 | 375 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 391 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 135 | $750K |
| Dental | DELTA DENTAL OF NEW YORK | 754 | $481K |
| Vision | VISION SERVICE PLAN | 233 | $50K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 375 | $412K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 375 | $412K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 135 | $750K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 375 | $420K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 754 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.