| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLARK INSURANCE3 | P.O. BOX 3543 PORTLAND, ME 04104 | ANTHEM HEALTH PLANS OF MAINE, INC. | $39K | — | $39K | 2.43% |
| CLARK INSURANCE3 | P.O. BOX 3543 PORTLAND, ME 041043543 | DELTA DENTAL PLAN OF MAINE | $5K | — | $5K | 4.32% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE BS | P.O. BOX 1320 CONCORD, NH 033021320 | DELTA DENTAL PLAN OF MAINE | $1K | — | $1K | 1.12% |
| CLARK INSURANCE3 Filed as: CLARK INSURANCE DBA TURNER BARKER | 2385 CONGRESS STREET PORTLAND, ME 04102 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 5.11% |
| CLARK INSURANCE3 | P.O. BOX 3543 PORTLAND, ME 04104 | ANTHEM LIFE INSURANCE COMPANY | $9K | — | $9K | 14.59% |
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 | 180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF MAINE, INC. | 656 | $1.6M |
| Dental | DELTA DENTAL PLAN OF MAINE | 330 | $106K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 208 | $64K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 180 | $76K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 208 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 656 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.