| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| E B S INSURANCE BROKERS, INC.3 Filed as: E B S INSURANCE BROKERS INC | 300 WASHINGTON ST, SUITE 650, NEWTON, MA 02458 NEWTON, MA 02458 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $115K | — | $115K | 2.03% |
| HAYS COMPANIES, INC.3 Filed as: HAYS GROUP, INC, THE | 133 FEDERAL ST BOSTON MA 02110 BOSTON, MA 02110 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $54K | $22K | $76K | 1.34% |
| PAUL ROONEY3 | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | KAISER FOUNDATION HEALTH PLAN INC | $20K | — | $20K | 1.86% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | PO BOX 1414 MINNEAPOLIS, MN 554801414 | KAISER FOUNDATION HEALTH PLAN INC | $11K | — | $11K | 1.04% |
| E B S INSURANCE BROKERS, INC.3 Filed as: E B S INSURANCE BROKERS INC | 300 WASHINGTON ST STE 650 NEWTON, MA 02458 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $20K | — | $20K | 2.69% |
| HAYS COMPANIES, INC.3 Filed as: HAYS GROUP, INC, THE | 133 FEDERAL ST BOSTON, MA 02210 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $9K | — | $9K | 1.29% |
| PAUL ROONEY3 | 1 GATEWAY CTR STE 650 NEWTON, MA 024582834 | KAISER FOUNDATION HEALTH PLAN INC | $9K | — | $9K | 3.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | PO BOX 1414 MINNEAPOLIS, MN 554801414 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.58% |
| EBS INSURANCE BROKERS3 | 300 WASHINGTON ST SUITE 650 NEWTON, MA 02458 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $2K | $11K | 4.23% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 133 FEDERAL ST SECOND FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 1.65% |
| EBS INSURANCE BROKERS3 | 300 WASHINGTON ST SUITE 650 NEWTON, MA 02458 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $2K | $6K | 3.67% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 133 FEDERAL ST SECOND FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $315 | — | $315 | 0.21% |
| EBS INSURANCE BROKERS3 | 300 WASHINGTON ST SUITE 650 NEWTON, MA 02458 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $1K | $6K | 5.46% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 133 FEDERAL ST SECOND FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $364 | — | $364 | 0.33% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS, INC. | ONE GATEWAY CENTERSUITE 650 NEWTON, MA 02458 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | — | $5K | 7.55% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES - | 133 FEDERAL STREET 3RD FLOOR BOSTON, MA 02110 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 2.45% |
| EBS INSURANCE BROKERS3 | 300 WASHINGTON ST SUITE 650 NEWTON, MA 02458 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $890 | $257 | $1K | 4.27% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 133 FEDERAL ST SECOND FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $453 | — | $453 | 1.69% |
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 | 654 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 659 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 871 | $7.0M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,283 | $726K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 949 | $61K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 654 | $252K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 117 | $152K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 654 | $110K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 210 | $1.4M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 654 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,283 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.