| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS BENEFIT SOLUTIONS3 | PO BOX 469 AUGUSTA, ME 04332 | ANTHEM HEALTH PLANS OF MAINE INC | — | $1K | $1K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF MAINE INC EIN 31-1705652 THIRD PARTY ADMINISTRATOR | Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Float revenue Service code 12 | 1 GANNETT DRIVE SOUTH PORTLAND, ME 04106 | $489K |
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 | 753 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 753 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF MAINE INC | 753 | $0 |
| Vision | ANTHEM HEALTH PLANS OF MAINE INC | 753 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 753 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.