| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK AND BOARDMAN | — | BLUE CROSS BLUE SHIELD OF VERMONT | — | $3K | $3K | 0.10% |
| COMBINED SERVICES LLC3 | PO POX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF VERMONT, INC. | $676 | — | $676 | 0.56% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK AND BOARDMAN | 346 SHELBURNE RD 5TH FL BURLINGTON, VT 05401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 8.39% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK AND BOARDMAN | 346 SHELBURNE RD 5TH FL BURLINGTON, VT 05401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 16.42% |
| COMBINED SERVICES LLC3 | PO POX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF VERMONT, INC. | $209 | — | $209 | 1.10% |
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 | 521 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 537 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF VERMONT | 459 | $3.1M |
| Dental(2 contracts) | DELTA DENTAL PLAN OF VERMONT, INC. | 244 | $140K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF VERMONT | 459 | $3.2M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 258 | $112K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 258 | $83K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF VERMONT | 459 | $3.1M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 258 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 459 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.