| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $24K | $7K | $31K | 3.71% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 80 SOUTH 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $1K | — | $1K | 2.50% |
| JEREMY FRYE & ASSOCIATES INC3 Filed as: JEREMY TAYLOR STOWE | 275 PROMENADE ST SUITE 300 PROVIDENCE, RI 02908 | NORTHWEST MUTUAL | $1K | $300 | $2K | 11.92% |
| JEFFREY A IMLAY3 | 5251 W 116TH PL SUITE 300 LEAWOOD, KS 66211 | NORTHWEST MUTUAL | $517 | $129 | $646 | 5.11% |
| FRIELING INS AGY INC3 Filed as: FRIELING INS AGENCY INC | 55 WILLIAM ST SUITE 100 WELLESLEY, MA 02481 | NORTHWEST MUTUAL | $166 | $40 | $206 | 1.63% |
| RPS BENEFITS INC3 Filed as: RPS FNCL GRP INC | 5251 W 116TH PL SUITE 300 LEAWOOD, KS 66211 | NORTHWEST MUTUAL | $71 | $9 | $80 | 0.63% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $677 | — | $677 | 14.97% |
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 | 123 | 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) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 69 | $849K |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 108 | $60K |
| Vision | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 46 | $5K |
| Life insurance | NORTHWEST MUTUAL | 123 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.