| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 530 PRESTON AVENUE MERIDEN, CT 06450 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $17K | $0 | $17K | 3.04% |
| CROSS INSURANCE3 | 1100 ELM STREET MANCHESTER, NH 03101 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $5K | $0 | $5K | 0.94% |
| USI INSURANCE SERVICES LLC3 | 530 PRESTON AVENUE MERIDEN, CT 06450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $3K | $10K | 10.66% |
| HPHC INSURANCE AGENCY, INC.3 | 93 WORCESTER STREET WELLESLEY HILLS, MA 02481 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 6.00% |
| FIAI INC3 Filed as: FIAI INC. | 1100 ELM STREET MANCHESTER, NH 03101 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 2.21% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $3K | $0 | $3K | 4.21% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $935 | $0 | $935 | 1.26% |
| FIAI INC3 Filed as: FIAI INC. | 1100 ELM STREET MANCHESTER, NH 03101 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $602 | $0 | $602 | 0.81% |
| THOMAS SCANLON3 | 121 ROLLING MEADOW DRIVE HOLLISTON, MA 01746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $300 | $0 | $300 | 2.13% |
| JAMES A. THOMPSON3 Filed as: JAMES A THOMPSON | 299 COLBY ROAD WEARE, NH 03281 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $176 | $0 | $176 | 1.25% |
| STEPHEN CORRIVEAU3 | 420 GRANGE ROAD NORTH SMITHFIELD, RI 02896 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $162 | $0 | $162 | 1.15% |
| MELISSA J LINDSEY3 Filed as: MELISSA J. LINDSEY | 152 HARRIS ROAD SMITHFIELD, RI 02917 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $68 | $0 | $68 | 0.48% |
| FLEURY ENTERPRISES INC3 Filed as: FLEURY ENTERPRISES AND MISC AGENTS | 162 INDIAN POINT ROAD TIVERTON, RI 02878 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | $0 | $63 | 0.45% |
| ENROLLMENT SOLUTIONS LTD3 | 65 BURBANK ROAD SUTTON, MA 01590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.18% |
| ROBERT S. TAPPAN3 | 300 OHIO AVENUE MANCHESTER, NH 03104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | $0 | $24 | 0.17% |
No Schedule C service providers reported on this filing.
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. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | 90 | $543K |
| Dental | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | 118 | $74K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 179 | $105K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 179 | $105K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 179 | $91K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | 90 | $543K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 179 | $105K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.