| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | AETNA LIFE INSURANCE CO. | $24K | — | $24K | 3.19% |
| CLARK INSURANCE3 | 1945 CONGRESS STREET BUILDING A PO BOX 3543 PORTLAND, ME 04104 | DELTA DENTAL PLAN OF MAINE | $4K | — | $4K | 4.95% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE BEN | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF MAINE | $1K | — | $1K | 1.29% |
| CLARK INSURANCE3 | 1945 CONGRESS STREET SUITE A PORTLAND, ME 04102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| CLARK INSURANCE3 | 1945 CONGRESS STREET SUITE A PORTLAND, ME 04102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CLARK INSURANCE3 | 1945 CONGRESS STREET SUITE A PORTLAND, ME 04102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 14.87% |
| CLARK INSURANCE3 | 1945 CONGRESS STREET SUITE A PORTLAND, ME 04102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| CLARK INSURANCE3 | 1945 CONGRESS STREET BUILDING A PO BOX 3543 PORTLAND, ME 04104 | RED TREE INSURANCE COMPANY, INC. | $822 | — | $822 | 10.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE BEN | PO BOX 1320 CONCORD, NH 03302 | RED TREE INSURANCE COMPANY, INC. | $123 | — | $123 | 1.50% |
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 | 118 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 185 | $764K |
| Dental | DELTA DENTAL PLAN OF MAINE | 190 | $85K |
| Vision | RED TREE INSURANCE COMPANY, INC. | 115 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $31K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 62 | $18K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $15K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $31K |
| 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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.