| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS INC | $38K | $10K | $48K | 2.33% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC. | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS INC | $6K | — | $6K | 3.31% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 5.49% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC | 1 GATEWAY CTR SUITE 650 NEWTON, MA 02458 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $4 | $9K | 15.01% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC. | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 9.05% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC. | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC | 1 GATEWAY CTR SUITE 650 NEWTON, MA 02458 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $54 | $1K | 15.75% |
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 | 170 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS INC | 382 | $2.1M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS INC | 416 | $186K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 179 | $24K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $92K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $49K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 179 | $86K |
| 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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.