| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS BENEFIT SOLUTIONS3 | 491 MAIN ST BANGOR, ME 04401 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 1.68% |
| CROSS BENEFIT SOLUTIONS3 | 491 MAIN ST BANGOR, ME 04401 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 4.79% |
| CROSS BENEFIT SOLUTIONS3 | 491 MAIN ST BANGOR, ME 04401 | STANDARD INSURANCE COMPANY | $14K | — | $14K | 18.54% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DR AUGUSTA, ME 043320469 | RED TREE INSURANCE CO, INC. | $4K | — | $4K | 5.81% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DR AUGUSTA, ME 044320469 | RED TREE INSURANCE CO, INC. | $3K | — | $3K | 4.17% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 033021320 | RED TREE INSURANCE CO, INC. | $914 | — | $914 | 1.50% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: BDMP RISK MANAGEMENT LLC | PO BOX 1100 PORTLAND, ME 041041100 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 13.88% |
| SUSAN G. MARGILOFF4 Filed as: SUSAN G MARGILOFF | 5025 HILLSBORO PIKE APT 2D NASHVILLE, TN 37215 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $5K | — | $5K | 11.28% |
| MELISSA J DALFONSO4 | 10 DECLARATION DRIVE WESTBROOK, ME 04092 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $37 | — | $37 | 0.08% |
| MARIANO HUERTA3 Filed as: MARIANO HUERTO ORTIZ | — | TRIPLE S SALUD, INC | $460 | — | $460 | 5.00% |
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 | 936 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 944 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 12 | $135K |
| Vision | RED TREE INSURANCE CO, INC. | 898 | $61K |
| Life insurance | STANDARD INSURANCE COMPANY | 880 | $351K |
| Long-term disability | STANDARD INSURANCE COMPANY | 869 | $108K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 898 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.