| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE, SUITE 2 AUGUSTA, ME 04330 | HARVARD PILGRIM HEALTH CARE | $35K | $0 | $35K | 3.19% |
| WOODROW W CROSS AGENCY3 Filed as: WOODROW W. CROSS AGENCY | PO BOX 1388 BANGOR, ME 04402 | ANTHEM LIFE INSURANCE COMPANY | $12K | $0 | $12K | 16.45% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE, SUITE 2 AUGUSTA, ME 04330 | ANTHEM LIFE INSURANCE COMPANY | $0 | $818 | $818 | 1.10% |
| HPHC INSURANCE AGENCY, INC.3 | 93 WORCESTER STREET WELLESLEY HILLS, MA 02481 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 6.00% |
| WOODROW W CROSS AGENCY3 Filed as: WOODROW W. CROSS AGENCY | PO BOX 1388 BANGOR, ME 04402 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 4.53% |
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 | 127 | 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) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 173 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 103 | $66K |
| Vision | ANTHEM HEALTH PLANS OF MAINE | 127 | $0 |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 127 | $74K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 127 | $74K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 127 | $74K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE | 173 | $1.1M |
| Other | ANTHEM LIFE INSURANCE COMPANY | 127 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.