| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMMUNITY BANKS INSURANCE AGENCY3 | 2 THOMAS DRIVE WESTBROOK, ME 04092 | ANTHEM HEALTH PLANS OF MAINE, INC. | $3K | — | $3K | 0.19% |
| MFIT MAINE FINANCIAL INST INS3 | 2 THOMAS DR WESTBROOK, ME 04092 | DELTA DENTAL PLAN OF MAINE | $25K | — | $25K | 2.19% |
| COMMUNITY BANKS INSURANCE AGENCY3 | 2 THOMAS DR WESTBROOK, ME 04092 | DELTA DENTAL PLAN OF MAINE | $6K | — | $6K | 2.27% |
| MFIT MAINE FINANCIAL INST INS3 | 2 THOMAS DR WESTBROOK, ME 04092 | DELTA DENTAL PLAN OF MAINE | $5K | — | $5K | 2.16% |
| COMMUNITY BANKS INSURANCE AGENCY3 | 2 THOMAS DR WESTBROOK, ME 04092 | VISION SERVICE PLAN | $24K | — | $24K | 10.00% |
| COMMUNITY BANKS INSURANCE AGENCY3 | 2 THOMAS DR WESTBROOK, ME 04092 | ANTHEM BLUE CROSS BLUE SHIELD | $3K | — | $3K | 2.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MAINE BANKERS ASSOCIATION EIN 01-0155360 PLAN SPONSOR | Contract Administrator Service code 13 | — | $784K |
| TRACEY ALLEN, LLC EIN 26-3779243 SERVICE PROVIDER | Consulting (general) Service code 16 | — | $495K |
| BUSINESS SOLVER EIN 42-1503807 SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $92K |
| BERRYDUNN EIN 01-0391345 PROFESSIONAL SERVICES | Accounting (including auditing) Service code 10 | — | $51K |
| HEALTH AXIS EIN 45-5531595 SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $26K |
| ASSOCIATION SERVICES, INC. EIN 01-0507289 AFFILIATE OF PLAN SPONSOR | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $14K |
| NOVAREST EIN 45-0462799 SERVICE PROVIDER | Consulting (general) Service code 16 | — | $13K |
| DISCOVERY BENEFITS EIN 22-3339704 SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $9K |
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 | 2,668 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 312 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,980 | 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. | 4,182 | $1.7M |
| Dental(2 contracts) | DELTA DENTAL PLAN OF MAINE | 3,187 | $1.4M |
| Vision(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF MAINE, INC. | 4,182 | $1.8M |
| Life insurance(2 contracts, 2 carriers) | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 2,673 | $623K |
| Short-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 777 | $179K |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 2,444 | $352K |
| Prescription drug | ANTHEM BLUE CROSS BLUE SHIELD | 91 | $164K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF MAINE, INC. | 4,182 | $1.5M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,098 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,182 | — |
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.