| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NEW ENGLAND EMPLOYEE BENEFITS CO3 | 15 CHENELL DRIVE CONCORD, NH 03301 | STANDARD INSURANCE COMPANY | $4K | $916 | $5K | 4.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ULTRABENEFITS INC EIN 04-3525752 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 763 WESTBORO, MA 01581 | $120K |
| CIGNA EIN 59-1031071 PPO NETWORK | Other services Service code 49 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $0 |
| NEW ENGLAND EMPLOYEE BENEFITS EIN 02-0452548 PRODUCER | Insurance agents and brokers Service code 22 | 15 CHENELL DRIVE CONCORD, NH 03301 | $0 |
| PATIENT ADVOCATES CM EIN 01-0372148 CASE MANAGEMENT | Other services Service code 49 | 2 INTERNATIONAL DRIVE 200 PORTSMOUTH, NH 03801 | $0 |
| PHIL SOULE EIN 35-2425050 BROKER | Insurance agents and brokers Service code 22 | 309 WIANNO AVENUE OSTERVILLE, MA 02655 | $0 |
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 | 403 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 403 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | STANDARD INSURANCE COMPANY | 403 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 403 | — |
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.