| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $24K | — | $24K | 4.35% |
| CLARK INSURANCE3 | — | HPHC INSURANCE COMPANY | $15K | — | $15K | 4.35% |
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $10K | — | $10K | 4.35% |
| CLARK INSURANCE3 | — | HPHC INSURANCE COMPANY | $9K | — | $9K | 4.35% |
| CLARK INSURANCE3 | — | HPHC INSURANCE COMPANY | $8K | — | $8K | 4.35% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | AMERITAS LIFE INSURANCE CORP. | $4K | $633 | $4K | 3.28% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $1K | $10K | 9.96% |
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $4K | — | $4K | 4.35% |
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $4K | — | $4K | 4.35% |
| CLARK INSURANCE3 | — | HPHC INSURANCE COMPANY | $4K | — | $4K | 4.35% |
| CLARK INSURANCE3 | — | HPHC INSURANCE COMPANY | $3K | — | $3K | 4.35% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $238 | $3K | 16.25% |
| CLARK INSURANCE3 | — | HPHC INSURANCE COMPANY | $547 | — | $547 | 4.35% |
| CLARK INSURANCE3 | 1945 CONGRESS STREET BUILDING A PORTLAND, ME 04102 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 12.77% |
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $274 | — | $274 | 4.35% |
| 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 | $379 | — | $379 | 6.31% |
| CLARK INSURANCE3 | — | HPHC INSURANCE COMPANY | $222 | — | $222 | 4.34% |
| CLARK INSURANCE3 | — | HPHC INSURANCE COMPANY | $221 | — | $221 | 4.34% |
| 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 | $281 | — | $281 | 5.69% |
| CLARK INSURANCE3 | — | HPHC INSURANCE COMPANY | $140 | — | $140 | 4.34% |
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | -$46 | — | -$46 | — |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(15 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 98 | $1.9M |
| Dental | AMERITAS LIFE INSURANCE CORP. | 205 | $127K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 205 | $137K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 230 | $127K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 230 | $102K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 230 | $102K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 230 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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."
No prospect flags tripped on this filing.