| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLARK INSURANCE3 | P.O. BOX 3543 PORTLAND, ME 041043543 | HARVARD PILGRIM HEALTH CARE | $49K | — | $49K | 2.63% |
| CLARK INSURANCE3 | P.O. BOX 3543 PORTLAND, ME 041043543 | DELTA DENTAL PLAN OF MAINE | $5K | — | $5K | 3.94% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE | P.O. BOX 1320 CONCORD, NH 033021320 | DELTA DENTAL PLAN OF MAINE | $1K | — | $1K | 1.00% |
| CLARK INSURANCE3 | P.O. BOX 3543 PORTLAND, ME 041043543 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 4.92% |
| CLARK INSURANCE3 | P.O. BOX 3543 PORTLAND, ME 041043543 | HPHC INSURANCE COMPANY | $2K | — | $2K | 2.63% |
| CLARK INSURANCE3 | P.O. BOX 3543 PORTLAND, ME 041043543 | ANTHEM LIFE INSURANCE COMPANY | $11K | — | $11K | 15.17% |
| CLARK INSURANCE3 | P.O. BOX 3543 PORTLAND, ME 041043543 | HARVARD PILGRIM HEALTH CARE | $366 | — | $366 | 2.63% |
| CLARK INSURANCE3 | P.O. BOX 3543 PORTLAND, ME 041043543 | HARVARD PILGRIM HEALTH CARE | $216 | — | $216 | 2.64% |
| CLARK INSURANCE3 | P.O. BOX 3543 PORTLAND, ME 041043543 | HARVARD PILGRIM HEALTH CARE | $143 | — | $143 | 2.63% |
| CLARK INSURANCE3 | P.O. BOX 3543 PORTLAND, ME 041043543 | RED TREE INSURANCE COMPANY, INC. | $422 | — | $422 | 9.12% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE | P.O. BOX 1320 CONCORD, NH 033021320 | RED TREE INSURANCE COMPANY, INC. | $63 | — | $63 | 1.36% |
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 | 246 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 329 | $2.0M |
| Dental | DELTA DENTAL PLAN OF MAINE | 373 | $122K |
| Vision | RED TREE INSURANCE COMPANY, INC. | 83 | $5K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 241 | $73K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 315 | $96K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 241 | $73K |
| Other(5 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 329 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 373 | — |
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.