| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS INSURANCE3 Filed as: CROSS INSURANCE - MANCESTER | — | HARVARD PILGRIM HEALTH CARE OF NEW INC - MA | $25K | $0 | $25K | 1.18% |
| LOCKTON COMPANIES, LLC3 | 4725 PIEDMONT ROW DRIVE SUITE 510 CHARLOTTE, NC 28210 | HARVARD PILGRIM HEALTH CARE OF NEW INC - MA | $24K | $0 | $24K | 1.17% |
| LOCKTON COMPANIES, LLC3 | 14005 LIVE OAK AVENUE, SUITE 23878 IRWINDALE, CA 91706 | RELIASTAR LIFE INSURANCE COMPANY | $16K | $7K | $23K | 16.63% |
| FIAI INC3 Filed as: FIAI, INC. | 1100 ELM STREET MANCHESTER, NH 03102 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $4K | $0 | $4K | 2.87% |
| LOCKTON COMPANIES, LLC3 | 4725 PIEDMONT ROW DRIVE SUITE 510 CHARLOTTE, NC 28210 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $3K | $0 | $3K | 2.09% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $106 | $0 | $106 | 0.08% |
| FIAI INC3 Filed as: FIAI, INC. | 1100 ELM STREET MANCHESTER, NH 03102 | RED TREE INSURANCE COMPANY, INC. | $623 | $0 | $623 | 5.03% |
| LOCKTON COMPANIES, LLC3 | 4725 PIEDMONT ROW DRIVE SUITE 510 CHARLOTTE, NC 28210 | RED TREE INSURANCE COMPANY, INC. | $521 | $0 | $521 | 4.20% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC | PO BOX 1320 CONCORD, NH 03302 | RED TREE INSURANCE COMPANY, INC. | $172 | $0 | $172 | 1.39% |
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 | 149 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE OF NEW INC - MA | 348 | $2.1M |
| Dental | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | 297 | $132K |
| Vision | RED TREE INSURANCE COMPANY, INC. | 127 | $12K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 154 | $139K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 154 | $139K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 154 | $139K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE OF NEW INC - MA | 348 | $2.1M |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 154 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 348 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.