| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN MYERS3 | 1350 BELMONT STREET SUITE 108 BROCKTON, MA 02301 | ANTHEM HEALTH PLANS OF MAINE, INC. | $34K | $0 | $34K | 2.61% |
| EASTERN STATES INS. AGENCY, INC.3 Filed as: EASTERN STATES INSURANCE AGENCY INC | 50 PROSPECT STREET WALTHAM, MA 02453 | ANTHEM HEALTH PLANS OF MAINE, INC. | $2K | $0 | $2K | 0.12% |
| JOHN MYERS3 | 1350 BELMONT STREET SUITE 108 BROCKTON, MA 02767 | ANTHEM LIFE INSURANCE COMPANY | $5K | $0 | $5K | 13.00% |
| EASTERN STATES INS. AGENCY, INC.3 Filed as: EASTERN STATES INSURANCE AGENCY INC | 50 PROSPECT STREET WALTHAM, MA 02453 | ANTHEM LIFE INSURANCE COMPANY | $180 | $0 | $180 | 0.51% |
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 | 138 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF MAINE, INC. | 138 | $1.3M |
| Dental | ANTHEM HEALTH PLANS OF MAINE, INC. | 138 | $1.3M |
| Vision | ANTHEM HEALTH PLANS OF MAINE, INC. | 138 | $1.3M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 105 | $35K |
| Prescription drug | ANTHEM HEALTH PLANS OF MAINE, INC. | 138 | $1.3M |
| Other | ANTHEM LIFE INSURANCE COMPANY | 105 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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.