| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NATIONAL WORKSITE BENEFIT GROUP3 Filed as: NATIONAL WORKSITE BENEFIT GROUP6 | 6 E CHESTNUT ST, STE 520 AUGUSTA, ME 043305759 | DELTA DENTAL PLAN OF MAINE | $7K | — | $7K | 3.80% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA | CSONE BENEFIT SOLUTIONS P.O. BOX 1320 CONCORD, NH 033021320 | DELTA DENTAL PLAN OF MAINE | $134 | — | $134 | 0.07% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DR STE301 CONCORD, NH 03301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $7K | $7K | 10.67% |
| NATIONAL WORKSITE BENEFIT GROUP3 Filed as: NATIONAL WORKSITE BENEFIT GROUP INC | 6 E. CHESTNUT ST STE 520 AUGUSTA, ME 04330 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 6.83% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICE LIMITED LIABILITY | 2 DELTA DR. STE 301 CONCORD, NH 03301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 10.81% |
| NATIONAL WORKSITE BENEFIT GROUP3 Filed as: NATIONAL WORKSITE BENEFIT GROUP INC | 6E CHESTNUT ST STE 520 AUGUSTA, ME 04330 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 8.13% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DR. SUITE 301 CONCORD, NH 03301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 10.80% |
| NATIONAL WORKSITE BENEFIT GROUP3 Filed as: NATIONAL WORKSITE BENEFIT GROUP INC | 6 E. CHESTNUT ST STE 520 AUGUSTA, ME 04330 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 20.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DR STE 301 CONCORD, NH 03301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 10.95% |
| NATIONAL WORKSITE BENEFIT GROUP3 | 6 E CHESTNUT ST STE 520 AUGUSTA, ME 04330 | VISION SERVICE PLAN | $1K | — | $1K | 5.67% |
| NATIONAL WORKSITE BENEFIT GROUP3 | 6 EAST CHESTNUT STREET SUITE 520 AUGUSTA, ME 04330 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $123 | — | $123 | 15.04% |
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 | 308 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 313 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL PLAN OF MAINE | 202 | $179K |
| Vision | VISION SERVICE PLAN | 172 | $19K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 336 | $93K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $64K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 308 | $45K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 336 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 336 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.