| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMBINED SERVICES LLC3 | DBA CSONE BENEFIT SOLUTIONS PO BOX 1320 CONCORD, NH 033021320 | DELTA DENTAL PLAN OF VERMONT, INC. | $715 | — | $715 | 1.24% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE AUGUSTA, ME 04330 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $942 | — | $942 | 5.00% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE AUGUSTA, ME 04330 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $849 | — | $849 | 5.00% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE AUGUSTA, ME 04330 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $371 | — | $371 | 5.00% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE AUGUSTA, ME 04330 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $363 | — | $363 | 5.00% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE AUGUSTA, ME 04330 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $329 | — | $329 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF VT EIN 03-0277307 CONTRACT ADM | Claims processing; Insurance services; Contract Administrator Service code 12 | — | $65K |
| CROSS BENEFIT SOLUTIONS BROKER | Insurance brokerage commissions and fees Service code 53 | 1233 SHELBURNE ROAD C-2A SOUTH BURLINGTON, VT 05403 | $31K |
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 | 153 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL PLAN OF VERMONT, INC. | 196 | $58K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 155 | $7K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 28 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 154 | $17K |
| Other(4 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF VERMONT | 191 | $351K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.