| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: BORISLOW INSURANCE AGENCY, INC. | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | BLUE CROSS AND BLUE SHIELD OF MINNESOTA AND BLUE PLUS | $71K | $0 | $71K | 4.00% |
| ASSUREDPARTNERS3 Filed as: BORISLOW INSURANCE AGENCY, INC. | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $148 | $1K | 0.80% |
| ASSUREDPARTNERS3 Filed as: BORISLOW INSURANCE AGENCY, INC. | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | $0 | $9K | 7.24% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 11788 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $5K | $5K | 4.44% |
| ASSUREDPARTNERS3 Filed as: BORISLOW INSURANCE AGENCY, INC. | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $1K | $0 | $1K | 10.97% |
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 | 142 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MINNESOTA AND BLUE PLUS | 259 | $1.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 396 | $178K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 204 | $13K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 188 | $122K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 188 | $122K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 188 | $122K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF MINNESOTA AND BLUE PLUS | 259 | $1.8M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 188 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 396 | — |
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.