| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE RICHARDS GROUP3 | PO BOX 820 BRATTLEBORO, VT 05302 | SYMETRA LIFE INSURANCE COMPANY | — | $41K | $41K | 3.84% |
| UNITED BENEFIT ADVISORS LLC3 | 20 NORTH WACKER DRIVE, SUITE 500 CHICAGO, IL 60606 | SYMETRA LIFE INSURANCE COMPANY | — | $7K | $7K | 0.63% |
| NEW HAMPSHIRE BANKERS SERVICES3 Filed as: NEW HAMPSHIRE BANKERS SERVICES LLC | PO BOX 2586 CONCORD, NH 03302 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $6K | — | $6K | 0.76% |
| NEW HAMPSHIRE BANKERS SERVICES3 Filed as: NEW HAMPSHIRE BANKERS SERVICES LLC | 2 EAGLE SQUARE, 2ND FLOOR CONCORD, NH 03302 | STANDARD INSURANCE COMPANY | $37K | $5K | $42K | 14.29% |
| NEW HAMPSHIRE BANKERS SERVICES3 Filed as: NEW HAMPSHIRE BANKERS SERVICES LLC | 2 EAGLE SQUARE, 2ND FLOOR CONCORD, NH 03302 | ANTHEM LIFE INSURANCE COMPANY | $12K | $0 | $12K | 12.55% |
| NEW HAMPSHIRE BANKERS SERVICES3 Filed as: NEW HAMPSHIRE BANKERS SERVICES LLC | PO BOX 2586 CONCORD, NH 03302 | ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. | $7K | $0 | $7K | 9.77% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE RICHARDS GROUP EIN 03-0215988 CONSULTANT | Consulting (general) Service code 16 | — | $147K |
| BERNSTEIN SHUR LEGAL SERVICES | Legal Service code 29 | 100 MIDDLE E STREET WEST TOWER PORTLAND, ME 04101 | $51K |
| WIPFLI, LLP EIN 39-0758449 INDEPENDENT AUDITOR | Accounting (including auditing) Service code 10 | — | $44K |
| MASON & RICH, P.A. ACCOUNTING | Accounting (including auditing) Service code 10 | 6 BICENTENNTIAL SQUARE CONCORD, NH 03301 | $16K |
| MDX MEDICAL, INC. EIN 26-3441881 TECHNOLOGY | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $9K |
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 | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 7 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | 0 | $783K |
| Vision | ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. | 0 | $75K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 0 | $396K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 0 | $396K |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 0 | $396K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 0 | $1.1M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 0 | $396K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.