| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | AETNA LIFE INSURANCE CO. | $27K | — | $27K | 3.13% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 4.24% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | STANDARD INSURANCE COMPANY | $2K | $619 | $3K | 9.08% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | STANDARD INSURANCE COMPANY | $2K | $464 | $2K | 10.06% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | STANDARD INSURANCE COMPANY | $2K | $348 | $3K | 15.93% |
| CLARK INSURANCE3 | 1945 CONGRESS STREET BUILDING A PO BOX 3543 PORTLAND, ME 04104 | RED TREE INSURANCE COMPANY, INC. | $783 | — | $783 | 10.03% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE BEN | PO BOX 1320 CONCORD, NH 03302 | RED TREE INSURANCE COMPANY, INC. | $118 | — | $118 | 1.51% |
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 | 103 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 177 | $849K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 198 | $65K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 198 | $73K |
| Life insurance | STANDARD INSURANCE COMPANY | 101 | $30K |
| Short-term disability | STANDARD INSURANCE COMPANY | 64 | $21K |
| Long-term disability | STANDARD INSURANCE COMPANY | 101 | $16K |
| Other(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 198 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.