| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | — | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS INC | $37K | $0 | $37K | 1.89% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | — | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS INC | $6K | $0 | $6K | 3.35% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 190 RIVER RD SUMMIT, NJ 07901 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $5K | 14.36% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 190 RIVER RD SUMMIT, NJ 07901 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 14.21% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 62939 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE | $2K | $0 | $2K | 8.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 190 RIVER ROAD 3RD FLOOR SUMMIT, NJ 07902 | EYEMED VISION CARE | $335 | $0 | $335 | 1.67% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 190 RIVER RD SUMMIT, NJ 07901 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $745 | $3K | 14.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 180 PARK AVE 1ST FL FLORHAM PARK, NJ 07932 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 6.67% |
| GEORGE POURIA3 | 22 SANBORN TERRACE AMESBURY, MA 01913 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $656 | $45 | $701 | 4.04% |
| COMPREHENSIVE INSURANCE PROVIDERS3 | 799 CAMBRIDGE ST CAMBRIDGE, MA 02141 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $688 | $0 | $688 | 3.97% |
| GIANNI RICHIO3 | 18 RICKER CIRCLE SOUTH HAMILTON, MA 01982 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $272 | $40 | $312 | 1.80% |
| DB INSURANCE INC3 | 26 HOURIHAN ST UNIT 2 BEVERLY, MA 01915 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $90 | $4 | $94 | 0.54% |
| BRIAN LESSARD3 | PO BOX 1533 QUECHEE, VT 05059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $73 | $0 | $73 | 0.42% |
| JAMES MACDOUGALL GORDON3 | 4210 GREEN STREET MIDDLEBOROUGH, MA 02346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | $0 | $70 | 0.40% |
| THE WORKSIGHT GROUP LLC3 | 6 ELM ST UNIT 5 MADISON, NJ 07940 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $24 | $53 | 0.31% |
| KRISTEN V LESSARD3 | PO BOX 1533 QUECHEE, VT 05059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $0 | $50 | 0.29% |
| ELITE ADMINISTRATION3 | 313 HARKINS BLUFF DR GREER, SC 29651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | $0 | $49 | 0.28% |
| TIMOTHY J REED3 | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $0 | $21 | 0.12% |
| HOWARD HOROWITZ3 Filed as: HOWARD J HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.05% |
| CHRISTINE GORDON3 | 73 WARREN AVE PLYMOUTH, MA 02360 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.02% |
| MCNEIL VOLUNTARY BENEFITS GROUP3 | 9 ACORN CIRCLE MEDFIELD, MA 02052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.02% |
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 | 254 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS INC | 382 | $1.9M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS INC | 373 | $175K |
| Vision | EYEMED VISION CARE | 322 | $20K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 254 | $36K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 254 | $35K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 254 | $30K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 254 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 382 | — |
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.