No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EVOLENT HEALTH LLC EIN 45-3084136 CLAIMS ADMINSTRATION | Participant communication; Named fiduciary; Other services; Claims processing; Contract Administrator; Float revenue; Direct payment from the plan Service code 12 | 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON, VA 22203 | $3.7M |
| BEACON HEALTH, LLC EIN 45-2967056 RELATED TO EMPLOYER | Direct payment from the plan; Consulting (general) Service code 16 | 43 WHITING HILL RD BREWER, ME 04412 | $2.2M |
| GEISINGER INDEMNITY INSURANCE CO EIN 23-2815174 CLAIM ADMINISTRATION | Claims processing; Float revenue; Other services; Participant communication; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Named fiduciary Service code 12 | — | $1.0M |
| EASTERN MAINE HEALTHCARE SYSTEMS EIN 01-0527066 EMPLOYER | Consulting (general); Direct payment from the plan; Contract Administrator Service code 13 | 43 WHITING HILL RD BREWER, ME 04412 | $215K |
| ACADIA BENEFITS EIN 01-0458116 CONSULTANT | Consulting (pension); Direct payment from the plan Service code 17 | 111 COMMERCIAL STREET 5TH FLOOR PORTLAND, ME 04101 | $174K |
| BERRY DUNN EIN 01-0523282 ACTUARIAL SERVICES | Actuarial; Accounting (including auditing) Service code 10 | 100 MIDDLE STREET PO BOX 1100 PORTLAND, ME 041041100 | $59K |
| BENEFIT STRATEGIES EIN 26-0003294 TPA | Direct payment from the plan; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 967 ELM STREET MANCHESTER, NH 03101 | $47K |
| EXCELLUS HEALTH PLAN, INC CLAIM ADMINISTRATION | Claims processing Service code 12 | 333 BUTTERNUT DRIVE SYRACUSE, NY 132141803 | $7K |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | IRONSHORE INDEMNITY, INC. | 0 | $532K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.