| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS INSURANCE3 Filed as: CROSS INSURANCE - MANCHESTER | 1100 ELM STREET MANCHESTER, NH 03101 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $24K | $0 | $24K | 1.92% |
| CROSS INSURANCE3 | 1100 ELM STREET MANCHESTER, NH 03101 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $6K | $0 | $6K | 1.85% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE - MANCHESTER | 1100 ELM STREET MANCHESTER, NH 03101 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $2K | $0 | $2K | 1.85% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE - MANCHESTER | 1100 ELM STREET MANCHESTER, NH 03101 | HPHC INSURANCE COMPANY | $2K | $0 | $2K | 1.85% |
| FIAI INC3 Filed as: FIAI INC. | 1100 ELM STREET MANCHESTER, NH 03101 | ANTHEM LIFE INSURANCE COMPANY | $9K | $0 | $9K | 10.94% |
| BUSINESS INSURANCE AGENCY DBA CROSS3 Filed as: BUSINESS INS AGENCY INC | 1085 BRIGHTON AVE PORTLAND, ME 04102 | ANTHEM LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.93% |
| CROSS INSURANCE3 | 1100 ELM STREET MANCHESTER, NH 03101 | HPHC INSURANCE COMPANY | $1K | $0 | $1K | 1.85% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE - MANCHESTER | 1100 ELM STREET MANCHESTER, NH 03101 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $329 | $0 | $329 | 1.85% |
| FIAI INC3 Filed as: FIAI, INC. | 1100 ELM STREET MANCHESTER, NH 03101 | RED TREE INSURANCE COMPANY, INC. | $1K | $0 | $1K | 11.78% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 033021320 | RED TREE INSURANCE COMPANY, INC. | $188 | $0 | $188 | 1.77% |
| CROSS INSURANCE3 | 1100 ELM STREET MANCHESTER, NH 03101 | HARVARD PILGRIM HEALTH CARE OF NE INC. - MA | $99 | $0 | $99 | 1.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL EIN 02-0273013 DENTAL CLAIMS PROCESSING | Claims processing Service code 12 | ONE DELTA DRIVE CONCORD, NH 033022002 | $23K |
| ANTHEM LIFE INSURANCE COMPANY EIN 35-0980405 ADMIN AGREEMENT | Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other services Service code 12 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 46204 | $8K |
| BENEFIT STRATEGIES EIN 26-0003294 HRA/FSA CLAIMS ADMINISTRA | Contract Administrator; Claims processing Service code 12 | 967 ELM STREET MANCHESTER, NH 03101 | $5K |
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 | 291 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 291 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | 295 | $1.9M |
| Vision | RED TREE INSURANCE COMPANY, INC. | 184 | $11K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 276 | $87K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 276 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 295 | — |
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.