| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NIBRI BENEFIT SERVICES INC3 | 512 CHESTER TPKE CANDIA, NH 030342207 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $26K | — | $26K | 3.83% |
| NIBRI BENEFIT SERVICES INC3 | 512 CHESTER TPKE CANDIA, NH 030342207 | PRINCIPAL LIFE INSURANCE COMPANY | $13K | — | $13K | 7.06% |
| NIBRI BENEFIT SERVICES INC3 | 512 CHESTER TPKE CANDIA, NH 030342207 | HPHC INSURANCE COMPANY | $5K | — | $5K | 3.83% |
| NIBRI BENEFIT SERVICES INC3 | 512 CHESTER TPKE CANDIA, NH 030342207 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $1K | — | $1K | 3.83% |
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 | 118 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | 96 | $845K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 197 | $183K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 197 | $183K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 197 | $183K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 197 | $183K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 197 | $183K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.