| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 8110 EAST UNION AVENUE, SUITE 700 DENVER, CO 80237 | ANTHEM HEALTH PLANS OF MAINE, INC. | $46K | — | $46K | 1.86% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | $4K | $22K | 7.86% |
| AGIS NETWORK INC3 Filed as: AGIS NETWORK, INC. | 2122 KRATKY ROAD SAINT LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $729 | $9K | 3.22% |
| EXECUTIVE INSURANCE ADVISORS LLC3 Filed as: EXECUTIVE INSURANCE ADVISORS, LLC | PO BOX 59816 POTOMAC, MD 20859 | SUN LIFE ASSURANCE COMPANY OF CANADA | $27K | — | $27K | 10.00% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HUMANADENTAL INSURANCE COMPANY | $4K | — | $4K | 2.12% |
| KYES AGENCY, INC.3 Filed as: KYES AGENCY INC. | PO BOX 311 FARMINGTON, ME 04938 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $150 | — | $150 | 15.00% |
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 | 234 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 244 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF MAINE, INC. | 485 | $2.5M |
| Dental | HUMANADENTAL INSURANCE COMPANY | 191 | $183K |
| Vision | ANTHEM HEALTH PLANS OF MAINE, INC. | 485 | $2.5M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 236 | $281K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 239 | $271K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 239 | $271K |
| Prescription drug | ANTHEM HEALTH PLANS OF MAINE, INC. | 485 | $2.5M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 239 | $553K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 485 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.