| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS INSURANCE3 | 491 MAIN STREET BANGOR, ME 04401 | HARVARD PILGRIM HEALTHCARE OF NE INC - MA | $45K | — | $45K | 4.10% |
| CROSS INSURANCE3 | 491 MAIN STREET BANGOR, ME 04401 | HARVARD PILGRIM HEALTHCARE OF NE INC - MA | $11K | — | $11K | 4.02% |
| CROSS INSURANCE3 | 491 MAIN STREET BANGOR, ME 04401 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $7K | — | $7K | 4.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL PLAN OF NEW HAMPSHIRE, EIN 02-0273013 DENTAL CLAIMS PROCESSING | Claims processing Service code 12 | ONE DELTA DRIVE CONCORD, NH 03302 | $16K |
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 | 150 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HARVARD PILGRIM HEALTHCARE OF NE INC - MA | 188 | $1.6M |
| Other | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | 26 | $159K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.