| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DMS INSURANCE AGENCY OF NH3 Filed as: DMS INSURANCE AGENCY OF NH, LLC | 426 S MAIN ST. LACONIA, NH 03246 | RED TREE INSURANCE COMPANY, INC. | $2K | $0 | $2K | 9.87% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 033021320 | RED TREE INSURANCE COMPANY, INC. | $288 | $0 | $288 | 1.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH PLANS, INC ADMIN. | Claims processing Service code 12 | 1500 W PARK DR #330 WESTBOROUGH, MA 01581 | $2.6M |
| MELCHER & PRESCOTT INSURANCE BROKER | Insurance agents and brokers Service code 22 | 426 MAIN STREET LACONIA, NH 30246 | $65K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $44K |
| DELTA DENTAL PLAN OF NEW HAMPSHIRE, EIN 02-0273013 ADMIN | Claims processing Service code 12 | — | $15K |
| DMS INSURANCE AGENCY OF NH EIN 82-3113069 BROKER | Insurance agents and brokers Service code 22 | — | $3K |
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 | 189 | 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) | 189 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | RED TREE INSURANCE COMPANY, INC. | 296 | $19K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 189 | $485K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 296 | — |
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.