| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTON, RI 02852 | HARTFORD LIFE & ACCIDENT INS CO MEDICARE SUPPLEMENT | $38K | — | $38K | 15.77% |
| WEB TPA5 | 8500 FREEPORT PKYWY SOUTH IRVING, TX 75063 | HARTFORD LIFE & ACCIDENT INS CO MEDICARE SUPPLEMENT | $15K | $0 | $15K | 6.28% |
| NFP INSURANCE SERVICES INC Filed as: NFP PROPERTY & CASUALTY SERVICES | PO BOX 2127 SOUTH BURLINGTON, VT 05641 | HARTFORD LIFE & ACCIDENT INS CO MEDICARE SUPPLEMENT | $9K | $0 | $9K | 3.54% |
| SENIOR MARKET SALES INC5 Filed as: SENIOR MARKET SALES- OMAHA | 8420 WEST DODGE RD SUITE 500 OMAHA, NE 68114 | HARTFORD LIFE & ACCIDENT INS CO MEDICARE SUPPLEMENT | $1K | — | $1K | 0.48% |
| COMBINED SERVICES LLC3 | P.O. BOX 1320 CONCORD, NH 03302 | NORTHEAST DELTA DENTAL | — | — | $0 | 0.00% |
| NFP INSURANCE SERVICES INC3 | 340 MADISON AVE 21ST FL NEW YORK, NY 10173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 5.00% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 1901 ROXBOROUGH RD SUITE 300 CHARLOTTE, NC 28211 | HARTFORD LIFE AND ACCIDENT | — | $793 | $793 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH LIFE INSURANCE CO EIN 59-1031071 MEDICAL CLAIMS ADM SVC | Claims processing; Float revenue; Other services; Participant communication; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Named fiduciary Service code 12 | PO BOX 644546 PITTSBURGH, PA 15264 | $9.9M |
| ANNE HOULE EIN 03-0210827 SALARY FOR KEY EMPLOYEE | Employee (plan sponsor); Insurance services; Plan Administrator Service code 14 | P.O. BOX 345 BARRE, VT 05641 | $74K |
| ANN REGAN EIN 03-0210827 SALARY FOR EMPLOYEE | Employee (plan sponsor); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | PO BOX 345 BARRE, VT 05641 | $23K |
| NFP CORPORATE SERVICES EIN 51-0434666 AGENT BROKER | Insurance brokerage commissions and fees Service code 53 | 620 HINESBURG RD SOUTH BURLINGTON, VT 05407 | $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 | 536 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 173 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 709 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARTFORD LIFE & ACCIDENT INS CO MEDICARE SUPPLEMENT | 164 | $241K |
| Dental | NORTHEAST DELTA DENTAL | 503 | $129K |
| Vision | VISION SERVICE PLAN | 262 | $27K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 298 | $79K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH LIFE INSURANCE COMPANY | 533 | $744K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 533 | — |
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.