| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $11K | — | $11K | 2.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | — | HARVARD PILGRIM HEALTH CARE | $7K | — | $7K | 1.18% |
| CROSS BENEFIT SOLUTIONS3 | 1085 BRIGHTON AVENUE PORTLAND, ME 04102 | ANTHEM HEALTH PLANS OF MAINE, INC. | $4K | — | $4K | 0.93% |
| HOLDEN AGENCY3 Filed as: THE HOLDEN AGENCY | PO BOX 10610 PORTLAND, ME 04104 | ANTHEM HEALTH PLANS OF MAINE, INC. | $3K | — | $3K | 0.60% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | ANTHEM HEALTH PLANS OF MAINE, INC. | $1K | — | $1K | 0.32% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CLARK INSRUANCE | — | HPHC INSURANCE COMPANY | $5K | — | $5K | 2.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | — | HPHC INSURANCE COMPANY | $3K | — | $3K | 1.18% |
| CLARK INSURANCE3 | — | HPHC INSURANCE COMPANY | $5K | — | $5K | 2.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | — | HPHC INSURANCE COMPANY | $3K | — | $3K | 1.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 300 BALLARDVALE STREET WILMINGTON, MA 01887 | DELTA DENTAL PLAN OF MAINE | $2K | — | $2K | 2.52% |
| CLARK INSURANCE3 | 1945 CONGRESS STREET BUILDING A PO BOX 3543 PORTLAND, ME 04104 | DELTA DENTAL PLAN OF MAINE | $2K | — | $2K | 2.49% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE BEN | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF MAINE | $619 | — | $619 | 0.88% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $317 | $3K | 7.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND | PO BOX 709 96 SHAKER ROAD EAST LONGMEADOW, MA 01028 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $45 | $2K | 5.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $338 | $338 | 0.78% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $112 | $1K | 8.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND | PO BOX 709 96 SHAKER ROAD EAST LONGMEADOW, MA 01028 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 6.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $145 | $145 | 0.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | PO BOX 709 96 SHAKER ROAD EAST LONGMEADOW, MA 01028 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $698 | — | $698 | 6.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | PO BOX 709 96 SHAKER ROAD EAST LONGMEADOW, MA 01028 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $613 | — | $613 | 6.31% |
| CLARK INSURANCE3 | 1945 CONGRESS STREET BUILDING A PO BOX 3543 PORTLAND, ME 04104 | RED TREE INSURANCE COMPANY, INC. | $208 | — | $208 | 5.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 300 BALLARDVALE STREET WILMINGTON, MA 01887 | RED TREE INSURANCE COMPANY, INC. | $178 | — | $178 | 4.29% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE BEN | PO BOX 1320 CONCORD, NH 03302 | RED TREE INSURANCE COMPANY, INC. | $58 | — | $58 | 1.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND | PO BOX 709 96 SHAKER ROAD EAST LONGMEADOW, MA 01028 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $801 | — | $801 | 20.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND | PO BOX 709 96 SHAKER ROAD EAST LONGMEADOW, MA 01028 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $246 | — | $246 | 6.17% |
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 | 191 | 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) | 191 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | HARVARD PILGRIM HEALTH CARE | 100 | $1.5M |
| Dental | DELTA DENTAL PLAN OF MAINE | 218 | $70K |
| Vision | RED TREE INSURANCE COMPANY, INC. | 64 | $4K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 126 | $69K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 126 | $43K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 126 | $43K |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 126 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 218 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.