| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROGERSGRAY, INC.3 | 410 UNIVERSITY AVENUE NORWOOD, MA 02090 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | $25K | $0 | $25K | 1.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | $8K | $0 | $8K | 0.50% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4211 WEST BOYSCOUT BOULEVARD SUITE 800 TAMPA, FL 33607 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | $0 | $6K | $6K | 0.39% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 434 ROUTE 134 SOUTH DENNIS, MA 02660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 7.28% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.15% |
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 | 184 | 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) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | 247 | $1.7M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 184 | $96K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 184 | $96K |
| Prescription drug | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | 247 | $1.7M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 184 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 247 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.