| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $127K | $101K | $228K | 2.57% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | KAISER FOUNDATION HEALTH PLAN, INC. | $53K | $0 | $53K | 4.82% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | DELTA DENTAL OF MASSACHUSETTS | $17K | $8K | $25K | 3.31% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PARKWAY W VEVA 16, SUITE 320 BLUE BELL, PA 19422 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $51K | $51K | 7.62% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, PA 01844 | SUN LIFE ASSURANCE COMPANY OF CANADA | $21K | $0 | $21K | 3.17% |
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 | 993 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,012 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 1,579 | $10.0M |
| Dental | DELTA DENTAL OF MASSACHUSETTS | 1,748 | $749K |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 1,579 | $8.9M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 936 | $665K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 936 | $665K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 936 | $665K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 1,579 | $10.0M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 936 | $665K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,748 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.