| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NEW ENGLAND EMPLOYEE BENEFITS CO3 | 15 CHENELL DRIVE CONCORD, NH 03585 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 8.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ULTRABENEFITS INC EIN 04-3525752 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 763 WESTBORO, MA 01581 | $93K |
| FIRST HEALTH GROUP CORP EIN 20-1736437 PPO NETWORK | Other services Service code 49 | 3200 HIGHLAND AVENUE DOWNERS GROVE, IL 60515 | $0 |
| MULTIPLAN INC EIN 13-3068979 PPO NETWORK | Other services Service code 49 | 115 FIFTH AVENUE NEW YORK, NY 10003 | $0 |
| NATIONAL BILL AUDIT SERVICES EIN 20-0091768 CLAIMS AUDIT | Insurance agents and brokers Service code 22 | 5999 CENTRAL AVENUE SUITE 401 ST PETERSBURG, FL 33710 | $0 |
| NEW ENGLAND EMPLOYEE BENEFITS CO EIN 02-0452548 BROKER | Insurance agents and brokers Service code 22 | 15 CHENELL DRIVE CONCORD, NH 03301 | $0 |
| PATIENT ADVOCATES EIN 01-0525535 UR/CASE MANAGEMENT | Other services Service code 49 | 235 PORTLAND ROAD PO BOX 1959 GRAY, ME 04039 | $0 |
| PHIL SOULE EIN 35-2425050 BROKER | Insurance agents and brokers Service code 22 | 309 WIANNO AVENUE OSTERVILLE, MA 02655 | $0 |
| ZELIS EIN 31-1368946 CLAIMS/BILLING AUDITOR | Insurance agents and brokers Service code 22 | 2 CROSSROADS DRIVE BEDMINSTER, NJ 07921 | $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 | 361 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 361 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | US FIRE INSURANCE COMPANY | 361 | $394K |
| Life insurance | STANDARD INSURANCE COMPANY | 380 | $98K |
| Stop-loss / reinsurancereinsurance | US FIRE INSURANCE COMPANY | 361 | $394K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 380 | — |
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.