| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACADIA BENEFITS INC3 Filed as: ACADIA BENEFITS, INC. | 111 COMMERCIAL STREET, 5TH FLOOR PORTLAND, ME 04101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $32K | $0 | $32K | 6.88% |
| JOHN CONDON ACADIA BENEFITS INC3 Filed as: JOHN M. CONDON | 111 COMMERCIAL STREET PORTLAND, ME 04101 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | $0 | $5K | 9.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSOR | Participant communication; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Other services; Contract Administrator; Direct payment from the plan Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $404K |
| DELTA DENTAL PLAN OF VERMONT, INC. EIN 03-0219391 DENTAL CLAIMS PROCESSING | Claims processing Service code 12 | ONE DELTA DRIVE CONCORD, NH 033022002 | $30K |
| ACADIA BENEFITS, INC. INSURANCE BROKER | Insurance agents and brokers Service code 22 | 111 COMMERCIAL STREET, 5TH FLOOR PORTLAND, ME 04101 | $10K |
| CIGNA | Other services; Direct payment from the plan; Contract Administrator; Participant communication; Float revenue; Named fiduciary; Non-monetary compensation; Claims processing Service code 12 | — | $0 |
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 | 382 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 385 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 915 | $462K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 551 | $51K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 915 | $462K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 915 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.