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| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL PLAN OF NH INC EIN 02-0273013 PROVIDER | Claims processing Service code 12 | 1 DELTA DRIVE CONCORD, NH 03302 | $21K |
| BENEFIT STRATEGIES, LLC EIN 26-0003294 PROVIDER | Contract Administrator Service code 13 | PO BOX 1300 MANCHESTER, NH 03105 | $17K |
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 | 310 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 310 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MATTHEW THORNTON HEALTH PLAN | 373 | $2.8M |
| Vision | VISION SERVICE PLAN | 189 | $30K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 247 | $155K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 247 | $155K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 247 | $155K |
| Other | ANTHEM EMPLOYEE ASSISTANCE PROGRAM | 310 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 373 | — |
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.