| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE GRP OF NE | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | HARVARD PILGRIM HEALTH CARE OF NE INC | $30K | — | $30K | 2.76% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | 980 WASHINGTON STREET DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE OF NE INC | $11K | — | $11K | 1.05% |
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE GRP OF NE | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | HARVARD PILGRIM HEALTH CARE | $8K | — | $8K | 2.75% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | 980 WASHINGTON STREET DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE | $3K | — | $3K | 1.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $4K | — | $4K | 5.02% |
| COMBINED SERVICES LLC3 | DBA CSONE BENEFIT SOLUTIONS PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $736 | — | $736 | 0.85% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | 144 TURNPIKE RD SUITE 330 SOUTHBOROUGH, MA 01772 | SUNLIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 12.93% |
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE GRP OF NE | 80 S. 8TH STREET SUITE 700 MINNEAPOLIS, MN 55426 | HPHC INSURANCE COMPANY | $1K | — | $1K | 4.20% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS, LLC | 980 WASHINGTON STREET STE 325 DEDHAM, MA 02026 | HPHC INSURANCE COMPANY | $549 | — | $549 | 1.60% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $4K | — | $4K | 15.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA INC | 100 RIAL TO PLACE SUITE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | — | $194 | $194 | 0.73% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | P.O. BOX 745957 ATLANTA, GA 303745957 | FIDELITY SECURITY LIFE INSURANCE COMPANY DBA EYEMED | $1K | — | $1K | 9.47% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | P.O. BOX 745949 ATLANTA, GA 303745949 | FIDELITY SECURITY LIFE INSURANCE COMPANY DBA EYEMED | $78 | — | $78 | 0.71% |
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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE OF NE INC | 123 | $1.4M |
| Dental | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | 177 | $86K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY DBA EYEMED | 141 | $11K |
| Life insurance(2 contracts, 2 carriers) | SUNLIFE ASSURANCE COMPANY OF CANADA | 241 | $65K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 144 | $26K |
| Prescription drug(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE OF NE INC | 123 | $1.1M |
| Other(2 contracts, 2 carriers) | SUNLIFE ASSURANCE COMPANY OF CANADA | 241 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 241 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.