| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS LLC | 980 WASHINGTON ST STE 325 DEDHAM, MA 02026 | CIGNA | $6K | $63K | $69K | 2.35% |
| RT CONSULTING LLC3 | 4 MAIN STREET PETERBOROUGH, NH 034580000 | CIGNA | $2K | $20K | $22K | 0.75% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | 333 ELM ST 3RD FLOOR DEDHAM, MA 02026 | SYMETRA LIFE INSURANCE COMPANY | $13K | — | $13K | 5.87% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 446 MAIN ST 5TH FL WORCESTER, MA 01608 | SYMETRA LIFE INSURANCE COMPANY | $8K | — | $8K | 3.76% |
| RT CONSULTING LLC3 Filed as: RT CONSULTING OF THE NORTHEAST | 4 MAIN ST 2ND FLR PETERBOROUGH, NH 03458 | SYMETRA LIFE INSURANCE COMPANY | $6K | — | $6K | 2.47% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA | 980 WASHINGTON ST STE 325 DEDHAM, MA 02026 | VISION SERVICE PLAN | $1K | — | $1K | 3.86% |
| PHILIP HEALY3 | 4 MAIN ST PETERBOROUGH, NH 03458 | VISION SERVICE PLAN | $764 | — | $764 | 2.32% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $95K |
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 | 228 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 232 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA | 416 | $2.9M |
| Dental | CIGNA | 416 | $2.9M |
| Vision(2 contracts, 2 carriers) | CIGNA | 416 | $3.0M |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 339 | $226K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 339 | $226K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 339 | $226K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 339 | $226K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 416 | — |
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.