| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $33K | — | $33K | 3.16% |
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $11K | — | $11K | 3.16% |
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $8K | — | $8K | 3.16% |
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $7K | — | $7K | 3.16% |
| MARSH & MCLENNAN AGENCY LLC3 | 2385 CONGRESS STREET PORTLAND, ME 04104 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 9.55% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | AMERITAS LIFE INSURANCE CORP. | $3K | $2K | $6K | 4.42% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 3543 PORTLAND, ME 04104 | AMERITAS LIFE INSURANCE CORP. | $388 | — | $388 | 0.31% |
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $2K | — | $2K | 3.16% |
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $2K | — | $2K | 3.16% |
| CLARK INSURANCE3 | 1945 CONGRESS STREET BUILDING A PORTLAND, ME 04102 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 9.81% |
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $183 | — | $183 | 3.17% |
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $150 | — | $150 | 3.17% |
| CLARK INSURANCE3 | — | HARVARD PILGRIM HEALTH CARE | $128 | — | $128 | 3.17% |
| 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 | $80 | — | $80 | 6.30% |
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 | 242 | 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) | 242 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts) | HARVARD PILGRIM HEALTH CARE | 175 | $2.0M |
| Dental | AMERITAS LIFE INSURANCE CORP. | 473 | $124K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 473 | $136K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 245 | $134K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 245 | $133K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 245 | $133K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 245 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 473 | — |
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.