| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LORETTA HO SHERBLOM INS AGENCY INC3 | 199 PARK LN CONCORD, MA 01742 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $53K | $10K | $63K | 2.33% |
| LORETTA HO SHERBLOM INS AGENCY INC3 | 199 PARK LN CONCORD, MA 01742 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $1K | $5K | 6.36% |
| LORETTA HO SHERBLOM INS AGENCY INC3 | 199 PARK LN CONCORD, MA 01742 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $767 | $4K | 6.27% |
| LORETTA HO SHERBLOM INS AGENCY INC3 | 199 PARK LN CONCORD, MA 01742 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $604 | $5K | 10.15% |
| LORETTA HO SHERBLOM INS AGENCY INC3 | 199 PARK LN CONCORD, MA 01742 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 10.08% |
| LORETTA HO SHERBLOM INS AGENCY INC3 | 199 PARK LN CONCORD, MA 01742 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $225 | $1K | 11.11% |
| LORETTA HO SHERBLOM INS AGENCY INC3 | 199 PARK LN CONCORD, MA 01742 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $61 | $8 | $69 | 11.46% |
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 | 197 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 352 | $2.7M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 352 | $2.7M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 360 | $22K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 197 | $59K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 197 | $602 |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 197 | $47K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 352 | $2.7M |
| Other(3 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 197 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 360 | — |
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.