| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODROW W CROSS AGENCY3 | P.O. BOX 1388 BANGOR, ME 04402 | ANTHEM HEALTH PLANS OF MAINE, INC. | $22K | — | $22K | 2.58% |
| BUSINESS INSURANCE AGENCY3 Filed as: BUSINESS INSURANCE AGENCY INC | P.O. BOX 469 AUGUSTA, ME 04330 | ANTHEM HEALTH PLANS OF MAINE, INC. | $4K | — | $4K | 5.16% |
| WOODROW W CROSS AGENCY3 | P.O. BOX 1388 BANGOR, ME 04402 | ANTHEM LIFE INSURANCE COMPANY | $6K | — | $6K | 11.40% |
| BUSINESS INSURANCE AGENCY3 Filed as: BUSINESS INSURANCE AGENCY INC | 116 COMMUNITY DRIVE, SUITE 2 AUGUSTA, ME 04332 | ANTHEM LIFE INSURANCE COMPANY | — | $564 | $564 | 1.07% |
| BUSINESS INSURANCE AGENCY3 Filed as: BUSINESS INSURANCE AGENCY INC | P.O. BOX 469 AUGUSTA, ME 04330 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $869 | — | $869 | 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 | 161 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF MAINE, INC. | 190 | $856K |
| Dental | ANTHEM HEALTH PLANS OF MAINE, INC. | 101 | $80K |
| Vision | ANTHEM HEALTH PLANS OF MAINE, INC. | 190 | $856K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 150 | $53K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 150 | $53K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 26 | $6K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 150 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.