| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | AETNA LIFE INSURANCE CO | $16K | — | $16K | 2.18% |
| VARNEY & COMPANY BENEFITS ADVISORS3 | 32 OAK ST BANGOR, ME 04104 | AETNA LIFE INSURANCE CO | $7K | — | $7K | 0.98% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | AMERITAS LIFE INSURANCE CORP | $2K | $350 | $2K | 3.86% |
| VARNEY & COMPANY BENEFITS ADVISORS3 | 32 OAK ST BANGOR, ME 04401 | AMERITAS LIFE INSURANCE CORP | $638 | — | $638 | 1.01% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 5.80% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 6.68% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 10.37% |
| VARNEY & COMPANY BENEFITS ADVISORS3 | 32 OAK ST BANGOR, ME 04401 | RED TREE INSURANCE COMPANY INC | $272 | — | $272 | 3.47% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES | PO BOX 1320 CONCORD, NH 03302 | RED TREE INSURANCE COMPANY INC | $117 | — | $117 | 1.49% |
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 | 112 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO | 167 | $719K |
| Dental | AMERITAS LIFE INSURANCE CORP | 204 | $63K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP | 204 | $71K |
| Life insurance | STANDARD INSURANCE COMPANY | 112 | $36K |
| Short-term disability | STANDARD INSURANCE COMPANY | 69 | $24K |
| Long-term disability | STANDARD INSURANCE COMPANY | 112 | $19K |
| Other | AMERITAS LIFE INSURANCE CORP | 204 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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.