| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NEW ENGLAND EMPLOYEE BENEFITS CO3 Filed as: NEW ENGLAND EMPLOYEE BENEFITS | 15 CHENELL DRIVE CONCORD, NH 03301 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $610 | $3K | 12.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ULTRABENEFITS INC EIN 04-3525752 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 763 WESTBORO, MA 01581 | $78K |
| NEW ENGLAND EMPLOYEE BENEFITS CO EIN 02-0452548 BROKER | Insurance agents and brokers Service code 22 | 15 CHENELL DRIVE CONCORD, NH 03301 | $38K |
| PATIENT ADVOCATES EIN 01-0525535 UR/CASE MANAGEMENT | Other services Service code 49 | 235 PORTLAND ROAD PO BOX 1959 GRAY, ME 04039 | $27K |
| FIRST HEALTH GROUP CORP. EIN 20-1736437 PPO NETWORK | Other services Service code 49 | 3200 HIGHLAND AVENUE DOWNERS GROVE, IL 60515 | $18K |
| PREMIER HEALTHCARE EXCHANGE EIN 31-1368946 CLAIMS/BILLING AUDITOR | Insurance agents and brokers Service code 22 | 2 CROSSROADS DRIVE BEDMINSTER, NJ 07921 | $14K |
| MULTIPLAN, INC. EIN 13-3068979 PPO NETWORK | Other services Service code 49 | 115 FIFTH AVENUE NEW YORK, NY 10003 | $6K |
| CAREMARK EIN 75-2882129 PRESCRIPTION BENEFIT MGMT | Other services Service code 49 | 123 SUMMER STREET WORCESTER, MA 01608 | $4K |
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 | 361 | 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 |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 339 | $315K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 361 | $20K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 361 | $20K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 339 | $315K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 361 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.