| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MEMA EMPLOYEE BENEFIT PLAN2 | 25 GREENWOOD ROAD BRUNSWICK, ME 04011 | DELTA DENTAL PLAN OF MAINE | $12K | — | $12K | 3.98% |
| NATIONAL WORKSITE BENEFIT GROUP3 Filed as: NATIONAL WORKSITE BENEFIT GROUP INC | 6 E CHESTNUT ST, STE 520 AUGUSTA, ME 043305759 | DELTA DENTAL PLAN OF MAINE | $9K | — | $9K | 2.99% |
| COMBINED INSURANCE SVCS OF N FL INC3 Filed as: COMINED SERVICES LLC | PO BOX 1320 CONCORD, NH 033021320 | DELTA DENTAL PLAN OF MAINE | $2K | — | $2K | 0.55% |
| NATIONAL WORKSITE BENEFIT GROUP3 | 6 E CHESTNUT ST, #520 AUGUSTA, ME 043305759 | COMPANION LIFE INSURANCE COMPANY | $3K | — | $3K | 14.48% |
| COMBINED SERVICES LLC3 | 2 DELTA DRIVE, STE 301 CONCORD, NH 03301 | COMPANION LIFE INSURANCE COMPANY | $2K | — | $2K | 7.24% |
| NATIONAL WORKSITE BENEFIT GROUP3 Filed as: NATIONAL WORKSITE BENEFIT GROUP INC | PO BOX 487 HALLOWELL, ME 04347 | ANTHEM HEALTH PLANS OF MAINE, INC | $2K | — | $2K | 8.55% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIVERSIFIED ADMINISTRATION CORP EIN 06-0988547 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | 369 NORTH MAIN STREET MARLBOROUGH, CT 06447 | $381K |
| MAINE ENERGY MARKETERS ASSOCIATION EIN 01-0239259 ADMINISTRATOR | Plan Administrator Service code 14 | 25 GREENWOOD ROAD BRUNSWICK, ME 040110249 | $133K |
| WIPFLI LLP EIN 39-0758449 ACCOUNTANT | Accounting (including auditing) Service code 10 | ONE MARKET SQUARE AUGUSTA, ME 04330 | $27K |
| PRETI, FLAHERTY BELIVEAU & PACHIOS EIN 01-0502585 LEGAL | Legal Service code 29 | PO BOX 9546 PORTLAND, ME 041129546 | $15K |
| MMS ANALYTICS INC EIN 47-1212355 CONSULTING SERVICES | Consulting (general) Service code 16 | 99 BOW STREET, STE 100 E PORTSMOUTH, NH 03801 | $15K |
| BERNSTEIN, SHUR, SAWYER & NELSON EIN 01-0378211 LEGAL | Legal Service code 29 | 100 MIDDLE STREET PORTLAND, ME 04101 | $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 | 804 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 805 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL PLAN OF MAINE | 829 | $313K |
| Vision | ANTHEM HEALTH PLANS OF MAINE, INC | 243 | $19K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 572 | $23K |
| Stop-loss / reinsurancereinsurance | GERBER LIFE INSURANCE COMPANY | 316 | $332K |
| Other | COMPANION LIFE INSURANCE COMPANY | 572 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 829 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.