| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST | 299 BALLARDVALE STREET WILMINGTON, MA 01887 | ANTHEM MEDICARE PREFERRED PPO | $20K | — | $20K | 2.08% |
| S L MILLER INS. AGCY INC.3 | 401 EDGEWATER PL., SUITE 220 WAKEFIELD, MA 01880 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $12K | — | $12K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SEI INVESTMENTS EIN 23-3060382 NONE | Investment management; Trustee (directed); Trustee (bank, trust company, or similar financial institution); Direct payment from the plan; Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $76K |
| CARON & BLETZER, PLLC EIN 04-3499945 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $32K |
| ANTHEM HEALTH PLANS OF NEW HAMPSHIR EIN 02-0510053 ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Insurance brokerage commissions and fees; Other commissions; Contract Administrator; Float revenue; Other services; Insurance agents and brokers Service code 12 | — | $21K |
| CARON & BLETZER TS, PLLC EIN 47-2722581 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $8K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 353 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 353 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM MEDICARE PREFERRED PPO | 285 | $944K |
| Dental | ANTHEM MEDICARE PREFERRED PPO | 285 | $944K |
| Vision | ANTHEM MEDICARE PREFERRED PPO | 285 | $944K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 0 | $98K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF NEW HAMPSHIRE INC | 68 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 285 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.