| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAYSTATE BENEFIT SERVICES4 | 400 WASHINGTON STREET, STE 400 BRAINTREE, MA 02184 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | $36K | $3K | $40K | 4.12% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET, STE 400 BRAINTREE, MA 02184 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | $0 | $0 | $0 | 0.00% |
| INDIGO INSURANCE SERVICES3 | 101 HUTINGTON AVE BOSTON, MA 02199 | USABLE LIFE | $10K | — | $10K | 20.00% |
| BAYSTATE BENEFIT SERVICES3 | 400 WASHINGTON STREET SUITE 400 BRAINTREE, MA 02184 | EYEMED VISION | $712 | — | $712 | 9.95% |
| INDIGO INSURANCE SERVICES3 | 101 HUTINGTON AVE BOSTON, MA 02199 | USABLE | $1K | — | $1K | 19.99% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | 184 | $962K |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | 184 | $962K |
| Vision | EYEMED VISION | 98 | $7K |
| Life insurance | USABLE | 104 | $5K |
| Other | USABLE LIFE | 105 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 184 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
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.