| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODROW W CROSS AGENCY3 | 491 MAIN STREET BANGOR, ME 04401 | MONY LIFE INSURANCE COMPANY OF AMERICA | $39K | $0 | $39K | 13.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF MAINE, INC. EIN 31-1705652 CLAIM ADMINISTRATION | Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance agents and brokers; Float revenue; Contract Administrator; Claims processing; Insurance brokerage commissions and fees; Other commissions; Other services Service code 12 | — | $343K |
| AMERITAS LIFE INSURANCE CORP EIN 47-0098400 CLAIM ADMINISTRATION | Claims processing Service code 12 | PO BOX 81889 LINCOLN, NE 68501 | $13K |
| INGENIORX, INC. EIN 82-3062245 CLAIM ADMINISTRATION | Float revenue; Claims processing; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | -$25K |
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 | 428 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 428 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | MONY LIFE INSURANCE COMPANY OF AMERICA | 428 | $288K |
| Short-term disability | MONY LIFE INSURANCE COMPANY OF AMERICA | 428 | $288K |
| Long-term disability | MONY LIFE INSURANCE COMPANY OF AMERICA | 428 | $288K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF MAINE, INC. | 299 | $488K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 428 | — |
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.