| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FINANCIAL PLANING | 346 SHELBURNE RD PO BOX 1064 BURLINGTON, VT 05401 | MVP HEALTH CARE | $23K | — | $23K | 2.91% |
| NORTHERN BENEFIT CONSULTANTS LTD Filed as: NORTHERN BENEFIT CONSULTANTS | 1233 SHELBURNE RD STE C-2 S BURLINGTON, VT 05403 | MVP HEALTH CARE | $11K | — | $11K | 1.33% |
| NORTHERN BENEFITS3 Filed as: NORTHERN BENEFITS LTD | 1233 SHELBURNE RD STE C-2 S BURLINGTON, VT 05403 | NORTHEAST DELTA DENTAL | $2K | — | $2K | 3.17% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FINANCIAL PLANING | 346 SHELBURNE RD PO BOX 1064 BURLINGTON, VT 054011064 | NORTHEAST DELTA DENTAL | $1K | — | $1K | 2.28% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE BEN | PO BOX 1320 CONCORD, NH 033021320 | NORTHEAST DELTA DENTAL | $559 | — | $559 | 0.86% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FINANCIAL PLANING | 346 SHELBURNE RD BURLTINGTON, VT 05401 | VSP - VISION SERVICES PLAN | $601 | — | $601 | 5.03% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FINANCIAL PLANING | 346 SHELBURNE RD PO BOX 1064 BURLINGTON, VT 054011064 | PRINCIPAL LIFE INSURANCE COMPANY | $549 | $73 | $622 | 8.52% |
| NORTHERN BENEFIT CONSULTANTS LTD3 Filed as: NORTHERN BENEFIT CONSULTANTS | 1233 SHELBURNE RD STE C-2 S BURLINGTON, VT 054037780 | PRINCIPAL LIFE INSURANCE COMPANY | $545 | — | $545 | 7.47% |
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 | 130 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP HEALTH CARE | 148 | $791K |
| Dental | NORTHEAST DELTA DENTAL | 176 | $65K |
| Vision | VSP - VISION SERVICES PLAN | 101 | $12K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 130 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.