| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MFIT MAINE FINANCIAL INST INS3 | 489 CONGRESS ST PORTLAND, ME 04101 | DELTA DENTAL PLAN OF MAINE | $30K | — | $30K | 1.98% |
| EXPRESS SCRIPTS, INC.3 | PO BOX 52150 PHOENIX, AZ 85072 | ANTHEM HEALTH PLANS OF MAINE, INC. | — | $34K | $34K | 2.93% |
| COMMUNITY BANKS INSURANCE AGENCY3 | 2 THOMAS DR WESTBROOK, ME 04092 | ANTHEM HEALTH PLANS OF MAINE, INC. | $9K | — | $9K | 0.77% |
| COMMUNITY BANKS INSURANCE AGENCY3 | 489 CONGRESS ST PORTLAND, ME 04101 | DELTA DENTAL PLAN OF MAINE | $5K | — | $5K | 2.08% |
| MFIT MAINE FINANCIAL INST INS3 | 489 CONGRESS ST PORTLAND, ME 04101 | DELTA DENTAL PLAN OF MAINE | $5K | — | $5K | 1.98% |
| COMMUNITY BANKS INSURANCE AGENCY3 | 489 CONGRESS ST PORTLAND, ME 04101 | ANTHEM BLUE CROSS BLUE SHIELD | $5K | — | $5K | 2.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF MAINE, INC. EIN 31-1705652 SERVICE PROVIDER | Other services; Float revenue; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.5M |
| MAINE BANKERS ASSOCIATION EIN 01-0155360 PLAN SPONSOR | Contract Administrator Service code 13 | — | $848K |
| TRACEY ALLEN, LLC EIN 26-3779243 SERVICE PROVIDER | Consulting (general) Service code 16 | — | $550K |
| BUSINESS SOLVER EIN 42-1503807 SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $103K |
| COMPASS HEALTH ANALYTICS EIN 04-3375139 SERVICE PROVIDER | Consulting (general) Service code 16 | — | $41K |
| BERRYDUNN EIN 01-0391345 PROFESSIONAL SERVICES | Accounting (including auditing) Service code 10 | — | $16K |
| ADP, INC. EIN 22-3339704 SERVICE PROVIDER | Contract Administrator Service code 13 | — | $16K |
| ASSOCIATION SERVICES, INC. EIN 01-0507289 AFFILIATE OF PLAN SPONSOR | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $9K |
| EXPRESS SCRIPTS, INC. EIN 31-1714795 SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Claims processing Service code 12 | — | $0 |
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 | 3,085 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 252 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,337 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF MAINE, INC. | 9,208 | $1.3M |
| Dental(2 contracts) | DELTA DENTAL PLAN OF MAINE | 3,891 | $1.8M |
| Vision | ANTHEM HEALTH PLANS OF MAINE, INC. | 9,208 | $1.2M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,095 | $1.3M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,095 | $1.3M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,095 | $1.3M |
| Prescription drug | ANTHEM BLUE CROSS BLUE SHIELD | 117 | $170K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF MAINE, INC. | 9,208 | $1.2M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,095 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,208 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.