| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $153K | $0 | $153K | 2.39% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $44K | $0 | $44K | 0.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $13K | $370 | $13K | 4.44% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HARTFORD LIFE AND ACCIDENT | $0 | $3K | $3K | 1.11% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | HARTFORD LIFE AND ACCIDENT | $124 | $0 | $124 | 0.04% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 1801 K STREET NW, SUITE 200 WASHINGTON, DC 20006 | HARTFORD LIFE AND ACCIDENT | -$784 | $0 | -$784 | -0.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.41% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | VISION SERVICE PLAN | $810 | $0 | $810 | 1.45% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 417484 BOSTON, MA 02241 | VISION SERVICE PLAN | $22 | $0 | $22 | 0.04% |
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 | 552 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 34 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 586 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 852 | $6.4M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 852 | $6.4M |
| Vision | VISION SERVICE PLAN | 359 | $56K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 442 | $296K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 442 | $296K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 442 | $296K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 852 | $6.4M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 552 | $306K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 852 | — |
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.