| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS. AGENCY | 1 GRIFFIN BROOK DRIVE 2ND FLOOR METHUEN, MA 01844 | HARVARD PILGRIM HEALTH CARE | $29K | $0 | $29K | 1.67% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MASSACHUSETTS, INC. | 3 COPLEY PLACE, SUITE 300 BOSTON, MA 02116 | HARVARD PILGRIM HEALTH CARE | $24 | $0 | $24 | 0.00% |
| CROSS INSURANCE3 | 400 EDGEWATER PLACE STE 200 WAKEFIELD, MA 01880 | HARVARD PILGRIM HEALTH CARE | $8 | $0 | $8 | 0.00% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS. AGENCY | 1 GRIFFIN BROOK DRIVE 2ND FLOOR METHUEN, MA 01844 | HARVARD PILGRIM HEALTH CARE | $17K | $0 | $17K | 1.65% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MASSACHUSETTS, INC. | 3 COPLEY PLACE SUITE 300 BOSTON, MA 02116 | HARVARD PILGRIM HEALTH CARE | $14 | $0 | $14 | 0.00% |
| CROSS INSURANCE3 | 400 EDGEWATER PLACE WAKEFIELD, MA 01880 | HARVARD PILGRIM HEALTH CARE | $4 | $0 | $4 | 0.00% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS. AGENCY | ONE GRIFFIN BROOK DRIVE 2ND FLOOR METHUEN, MA 01844 | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $7K | $0 | $7K | 2.68% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW INS. AGENCY | 1 GRIFFIN BROOK DRIVE 2ND FLOOR METHUEN, MA 01844 | HPHC INSURANCE COMPANY | $1K | $0 | $1K | 1.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MASSACHUSETTS | 3 COPLEY PLACE STE 300 BOSTON, MA 02116 | HPHC INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BOARISLOW INS. AGENCY | 1 GRIFFIN BROOK DRIVE METHUEN, MA 01844 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.29% |
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 | 241 | 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) | 241 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 352 | $2.8M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 566 | $269K |
| Vision | VISION SERVICE PLAN | 177 | $24K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 241 | $67K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 241 | $67K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 241 | $67K |
| Prescription drug(3 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 352 | $2.8M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 241 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 566 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.