| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 190 RIVER ROAD SUITE 101 SUMMIT, NJ 07901 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | $35K | $0 | $35K | 2.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 190 RIVER ROAD SUITE 101 SUMMIT, NJ 07901 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | $6K | $0 | $6K | 3.34% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCES SERVICES NATIONAL | CN1011 190 RIVER ROAD SUMMIT, NJ 07901 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | CN1011 190 RIVER ROAD SUMMIT, NJ 07901 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 190 RIVER ROAD 3RD FLOOR SUMMIT, NJ 07902 | EYEMED VISION CARE | $2K | $0 | $2K | 10.69% |
| COMPREHENSIVE INSURANCE PROVIDERS3 | 799 CAMBRIDGE STREET CAMBRIDGE, MA 02141 | EYEMED VISION CARE | $680 | $0 | $680 | 3.57% |
| COMPREHENSIVE INSURANCE PROVIDERS3 | 4210 GREEN STREET MIDDLEBOROUGH, MA 02346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 6.33% |
| GEORGE POURIA3 | 22 SANBOM TERRACE AMESBURY, MA 01913 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $751 | $51 | $802 | 4.37% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 330 MADISON AVENUE NEW YORK, NY 10017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $685 | $0 | $685 | 3.73% |
| GIANNI RICHIO3 | 18 RICKER CIRCLE SOUTH HAMILTON, MA 01982 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $165 | $23 | $188 | 1.02% |
| DB INSURANCE INC3 | 26 HOURIHAN ST UNIT 2 PEABODY, MA 01960 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $111 | $77 | $188 | 1.02% |
| JAMES MACDOUGALL GORDON3 | 4210 GREEN STREET MIDDLEBOROUGH, MA 02346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $147 | $0 | $147 | 0.80% |
| BRIAN LESSARD3 | PO BOX 1533 QUECHEE, VT 05059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $103 | $0 | $103 | 0.56% |
| ELITE ADMINISTRATION3 | 313 HARKINS BLUFF DR GREER, SC 29651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | $0 | $77 | 0.42% |
| KRISTEN V LESSARD3 | PO BOX 1533 QUECHEE, VT 05059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | $0 | $75 | 0.41% |
| THE WORKSIGHT GROUP LLC3 | 6 ELM STREET UNIT 5 MADISON, NJ 07940 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $28 | $50 | 0.27% |
| TIMOTHY J REED3 | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $0 | $34 | 0.19% |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.05% |
| CHRISTINE GORDON3 | 73 WARREN AVE PLYMOUTH, MA 02360 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.03% |
| ROBERT W. HALLOCK3 Filed as: ROBERT MCGOWAN | 1 OLD SALEM CIRCLE SHREWSBURY, MA 01545 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | CN1011 190 RIVER ROAD SUMMIT, NJ 07901 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
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 | 233 | 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) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | 393 | $1.7M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | 384 | $170K |
| Vision | EYEMED VISION CARE | 308 | $19K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 233 | $33K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 233 | $33K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 233 | $26K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 233 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 393 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.