| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | HARVARD PILGRIM HEALTH CARE-HMO | $68K | — | $68K | 3.53% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | HPHC INSURANCE COMPANY | $16K | — | $16K | 3.53% |
| CLARK INSURANCE3 | 1835 CHICAGO AVE STE B RIVERSIDE, CA 925072309 | PRINCIPAL LIFE INSURANCE COMPANY | $14K | — | $14K | 7.86% |
| CLARK INSURANCE3 | 1945 CONGRESS ST BUILDING A PO BOX 3543 PORTLAND, ME 041043543 | DELTA DENTAL PLAN OF MAINE | $7K | — | $7K | 3.69% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SVCS LLC DBA CSONE BENEFIT | PO BOX 1320 CONCORD, NH 033021320 | DELTA DENTAL PLAN OF MAINE | $2K | — | $2K | 0.94% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | ANTHEM LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 04104 | HARVARD PILGRIM HEALTH CARE-HMO/HSA/NOHRA | $549 | — | $549 | 3.53% |
| CLARK INSURANCE3 | 1945 CONGRESS ST BUILDING A PO BOX 3543 PORTLAND, ME 041043543 | RED TREE INSURANCE COMPANY, INC. | $1K | — | $1K | 10.06% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SVCS LLC DBA CSONE BENEFIT | PO BOX 1320 CONCORD, NH 033021320 | RED TREE INSURANCE COMPANY, INC. | $218 | — | $218 | 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 | 291 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 292 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HARVARD PILGRIM HEALTH CARE-HMO | 304 | $2.4M |
| Dental | DELTA DENTAL PLAN OF MAINE | 412 | $177K |
| Vision | RED TREE INSURANCE COMPANY, INC. | 212 | $14K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 392 | $179K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 392 | $179K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 125 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 412 | — |
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.