| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK D FORTE3 | PO BOX 844 AUBURN, NH 030320844 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $23K | — | $23K | 3.44% |
| NIBRI BENEFIT SERVICES INC3 | 512 CHESTER TPKE CANDIA, NH 030342207 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $44 | — | $44 | 0.01% |
| MARK D FORTE3 | PO BOX 844 AUBURN, NH 030320844 | PRINCIPAL LIFE INSURANCE COMPANY | $16K | — | $16K | 6.91% |
| MARK D FORTE3 | PO BOX 844 AUBURN, NH 030320844 | HPHC INSURANCE COMPANY | $5K | — | $5K | 3.44% |
| NIBRI BENEFIT SERVICES INC3 | 512 CHESTER TPKE CANDIA, NH 030342207 | HPHC INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| MARK D FORTE3 | PO BOX 844 AUBURN, NH 030320844 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $1K | — | $1K | 3.44% |
| NIBRI BENEFIT SERVICES INC3 | 512 CHESTER TPKE CANDIA, NH 030342207 | HARVARD PILGRIM HEALTH CARE OF NE INC - MA | $3 | — | $3 | 0.01% |
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 | 127 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 127 | 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 | 81 | $874K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 202 | $228K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 202 | $228K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 202 | $228K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 202 | $228K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 202 | $228K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 202 | — |
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.