| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HICKOK & BOARDMAN FINANCIAL3 | PO BOX 1064 BURLINGTON, VT 054021064 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.28% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN HR INTELLIGENCE | 346 SHELBURNE ROAD PO BOX 1064 BURLINGTON, VT 054021064 | DELTA DENTAL PLAN OF VERMONT, INC. | $4K | $0 | $4K | 4.55% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC | PO BOX 1320 CONCORD, NH 033021320 | DELTA DENTAL PLAN OF VERMONT, INC. | $914 | $0 | $914 | 1.01% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FIN. PLANNING | PO BOX 1064 BURLINGTON, VT 054021064 | VISION SERVICE PLAN | $960 | $0 | $960 | 5.52% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN HR INTELLIGENCE | 346 SHELBURNE RD. FLOOR 5 BURLINGTON, VT 054014935 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $87 | $2K | 14.18% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN HR INTELLIGENCE | 346 SHELBURNE RD. FLOOR 5 BURLINGTON, VT 054014935 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $852 | $225 | $1K | 12.64% |
| PROSENTIAL BENEFITS LLC3 Filed as: PROSENTIAL BENEFITS, LLC | 100 STONEWALL BLVD. SUITE 1 WRENTHAM, MA 02093 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $64 | $64 | 0.75% |
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 | 169 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 208 | $453K |
| Dental | DELTA DENTAL PLAN OF VERMONT, INC. | 179 | $90K |
| Vision | VISION SERVICE PLAN | 109 | $17K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 37 | $12K |
| Short-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 48 | $21K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 37 | $12K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 208 | $453K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 208 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.