| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE, SUITE 2 AUGUSTA, ME 04330 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC | $29K | $0 | $29K | 1.78% |
| CROSS INSURANCE3 | 401 EDGEWATER PLACE, SUITE 100 WAKEFIELD, MA 01880 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC | $0 | $1K | $1K | 0.08% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04402 | DENTAL SERVICE OF MASSACHUSETTS INC DBA DELTA DENTAL OF MA | $2K | $0 | $2K | 2.74% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE, SUITE 2 AUGUSTA, ME 04330 | TUFTS INSURANCE COMPANY | $418 | $0 | $418 | 0.67% |
| CROSS INSURANCE3 | 401 EDGEWATER PLACE, SUITE 100 WAKEFIELD, MA 01880 | TUFTS INSURANCE COMPANY | $0 | $71 | $71 | 0.11% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE, SUITE 2 AUGUSTA, ME 04330 | STANDARD INSURANCE COMPANY | $1K | $512 | $2K | 6.05% |
| SAPERS & WALLACK3 Filed as: SAPERS & WALLACK INS AGENCY INC | 275 WASHINGTON STREET, SUITE 110 NEWTON, MA 02458 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $365 | $0 | $365 | 3.66% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 931 JEFFERSON BOULEVARD, SUITE 301 WARWICK, RI 02886 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $460 | $0 | $460 | 10.78% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 469 AUGUSTA, ME 04332 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $42 | $0 | $42 | 1.51% |
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 | 94 | 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) | 94 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC | 166 | $1.7M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS INC DBA DELTA DENTAL OF MA | 156 | $69K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 59 | $4K |
| Life insurance | STANDARD INSURANCE COMPANY | 101 | $28K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 19 | $10K |
| Prescription drug(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC | 166 | $1.7M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 101 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.