| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH ST, STE 700 MINNEAPOLIS, MN 55402 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $75K | $33K | $108K | 1.07% |
| CHANDOR INSURANCE AGENCY LLC3 | 177 MILK STREET SUITE 310 BOSTON, MA 02109 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $107K | — | $107K | 1.06% |
| CHANDOR INSURANCE AGENCY LLC3 | 177 MILK STREET SUITE 310 BOSTON, MA 02109 | DENTAL SERVICE OF MASSACHUSETTS, DBA DELTA DENTAL | $9K | — | $9K | 1.17% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | NCB 88 PO BOX 1414 MINNEAPOLIS, MN 55480 | DENTAL SERVICE OF MASSACHUSETTS, DBA DELTA DENTAL | $7K | — | $7K | 0.81% |
| CHANDOR INSURANCE AGENCY LLC3 Filed as: CHANDOR INSURANCE AGENCY, LLC | 177 MILK STREET, 3RD FLOOR BOSTON, MA 02109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $26K | $7K | $33K | 8.49% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 133 FEDERAL STREET 6TH FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 3.37% |
| CHANDOR INSURANCE AGENCY LLC3 Filed as: CHANDOR INSURANCE AGENCY, LLC | 177 MILK STREET, 3RD FLOOR BOSTON, MA 02109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | $5K | $25K | 8.52% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 133 FEDERAL STREET 6TH FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 3.34% |
| CHANDOR INSURANCE AGENCY LLC3 Filed as: CHANDOR INSURANCE AGENCY, LLC | 177 MILK STREET, 3RD FLOOR BOSTON, MA 02109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | $4K | $19K | 8.49% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 133 FEDERAL STREET 6TH FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 3.37% |
| CHANDOR INSURANCE AGENCY LLC3 Filed as: CHANDOR INSURANCE AGENCY, LLC | 177 MILK STREET, 3RD FLOOR BOSTON, MA 02109 | EYEMED VISION CARE | $6K | — | $6K | 9.20% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF NEW ENGLAND | 133 FEDERAL STREET FLOOR 6 BOSTON, MA 02110 | EYEMED VISION CARE | $1K | — | $1K | 1.54% |
| CHANDOR INSURANCE AGENCY LLC3 Filed as: CHANDOR INSURANCE AGENCY, LLC | 177 MILK STREET, 3RD FLOOR BOSTON, MA 02109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $1K | $5K | 8.47% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 133 FEDERAL STREET 6TH FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 3.45% |
| CHANDOR INSURANCE AGENCY LLC3 Filed as: CHANDOR INSURANCE AGENCY, LLC | 177 MILK STREET, 3RD FLOOR BOSTON, MA 02109 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $2K | $510 | $3K | 12.44% |
| CHANDOR INSURANCE AGENCY LLC3 Filed as: CHANDOR INS. AGENCY | 177 MILK STREET 3RD FLOOR BOSTON, MA 02109 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $590 | — | $590 | 5.82% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH ST. STE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $435 | — | $435 | 4.29% |
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 | 950 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 961 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,785 | $10.1M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, DBA DELTA DENTAL | 1,789 | $808K |
| Vision | EYEMED VISION CARE | 1,123 | $71K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 950 | $295K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 950 | $393K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 950 | $221K |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,001 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,789 | — |
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.