| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NOYLE W JOHNSON INC3 | PO BOX 279 MONTPELIER, VT 05601 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 4.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NORTHEAST DELTA DENTAL EIN 03-0219391 NONE | Claims processing Service code 12 | ONE DELTA DENTAL PO BOX 2002 CONCORD, NH 03302 | $61K |
| GRIPPIN DONLAN & PINKHAM, PLC EIN 03-0354347 NONE | Accounting (including auditing) Service code 10 | 3 BALDWIN AVENUE SOUTH BURLINGTON, VT 05403 | $17K |
| VERMONT AUTO DEALERS ASSOC. INC. EIN 03-0213537 PLAN SPONSOR | Plan Administrator Service code 14 | 1284 ROUTE 302 - BERLIN SUITE 2 BARRE, VT 05641 | $11K |
| HOOD & AYER EIN 03-0324363 NONE | Insurance agents and brokers Service code 22 | PO BOX 279 MONTPELIER, VT 05601 | $9K |
| UNUM EIN 01-0278678 NONE | Claims processing Service code 12 | PO BOX 406955 ALTLANTA, GA 30384 | $7K |
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 | 2,209 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,109 | $75K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,109 | $75K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,109 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,109 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.