| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS BENEFIT SOLUTIONS3 | PO BOX 469 AUGUSTA, ME 04330 | HARVARD PILGRIM HEALTH CARE POS HSA 5000 | $28K | — | $28K | 3.00% |
| MJ INSURANCE3 Filed as: CROSS FINANCIAL INSURANE | 491 MAIN STREET BANGOR, ME 04401 | HARVARD PILGRIM HEALTH CARE POS HSA 5000 | $10K | — | $10K | 1.05% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04401 | HARVARD PILGRIM HEALTH CARE POS HSA 3000 | $14K | — | $14K | 3.00% |
| CROSS BENEFIT SOLUTIONS3 Filed as: CROSS FINANCIAL INSURANCE | 491 MAIN STREET BANGOR, ME 04401 | HARVARD PILGRIM HEALTH CARE POS HSA 3000 | $5K | — | $5K | 1.05% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04401 | HARVARD PILGRIM HEALTH CARE HMO | $5K | — | $5K | 3.00% |
| CROSS BENEFIT SOLUTIONS3 Filed as: CROSS FINANCIAL INSURANCE | 491 MAIN STREET BANGOR, ME 04401 | HARVARD PILGRIM HEALTH CARE HMO | $2K | — | $2K | 1.05% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DR AUGUSTA, ME 043320469 | DELTA DENTAL PLAN OF MAINE | $6K | — | $6K | 4.96% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE BEN | PO BOX 1320 CONCORD, NH 033021320 | DELTA DENTAL PLAN OF MAINE | $948 | — | $948 | 0.84% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04401 | UNUM LIFE INS CO OF AMERICA - 5130 | $8K | — | $8K | 7.74% |
| CROSS INSURANCE3 | 491 MAIN ST PO BOX 1388 BANGOR, ME 04401 | UNUM LIFE INS CO OF AMERICA - 5130 | — | $2K | $2K | 1.83% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04401 | UNUM LIFE INS CO OF AMERICA - 5131 | $5K | — | $5K | 15.00% |
| CROSS INSURANCE3 | 491 MAIN ST PO BOX 1388 BANGOR, ME 04401 | UNUM LIFE INS CO OF AMERICA - 5131 | — | $663 | $663 | 2.00% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04401 | HPHC POSHSA 3000 COBRA | $466 | — | $466 | 3.00% |
| CROSS BENEFIT SOLUTIONS3 Filed as: CROSS FINANCIAL INSURANCE | 491 MAIN STREET BANGOR, ME 04401 | HPHC POSHSA 3000 COBRA | $164 | — | $164 | 1.06% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04401 | HARVARD PILGRIM HEALTH CARE HMO COBRA | $346 | — | $346 | 3.00% |
| CROSS BENEFIT SOLUTIONS3 Filed as: CROSS FINANCIAL INSURANCE | 491 MAIN STREET BANGOR, ME 04401 | HARVARD PILGRIM HEALTH CARE HMO COBRA | $122 | — | $122 | 1.06% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04401 | UNUM INSURANCE COMPANY - GROUP ACCIDENT | $662 | — | $662 | 10.19% |
| CROSS INSURANCE3 | 491 MAIN STREET PO BOX 1388 BANGOR, ME 04401 | UNUM INSURANCE COMPANY - GROUP ACCIDENT | — | $225 | $225 | 3.46% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04401 | UNUM INSURANCE COMPANY - CRITICAL ILLNESS | $948 | — | $948 | 14.99% |
| CROSS INSURANCE3 | 491 MAIN STREET PO BOX 1388 BANGOR, ME 04401 | UNUM INSURANCE COMPANY - CRITICAL ILLNESS | — | $316 | $316 | 5.00% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04401 | UNUM INSURANCE COMPANY - HOSPITAL | $709 | — | $709 | 13.79% |
| CROSS INSURANCE3 | 491 MAIN STREET PO BOX 1388 BANGOR, ME 04401 | UNUM INSURANCE COMPANY - HOSPITAL | — | $236 | $236 | 4.59% |
| CROSS BENEFIT SOLUTIONS3 | PO BOX 1388 BANGOR, ME 04401 | HARVARD PILGRIM HEALTH CARE POSHSA 5000 COBRA | $13 | — | $13 | 2.97% |
| CROSS BENEFIT SOLUTIONS3 Filed as: CROSS FINANCIAL INSURANCE | 491 MAIN STREET BANGOR, ME 04401 | HARVARD PILGRIM HEALTH CARE POSHSA 5000 COBRA | $5 | — | $5 | 1.14% |
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 | 175 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | HARVARD PILGRIM HEALTH CARE POS HSA 5000 | 192 | $1.6M |
| Dental | DELTA DENTAL PLAN OF MAINE | 230 | $113K |
| Life insurance | UNUM LIFE INS CO OF AMERICA - 5130 | 212 | $102K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INS CO OF AMERICA - 5130 | 212 | $109K |
| Long-term disability | UNUM LIFE INS CO OF AMERICA - 5130 | 212 | $102K |
| Other(8 contracts, 8 carriers) | HARVARD PILGRIM HEALTH CARE POS HSA 5000 | 192 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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."
No prospect flags tripped on this filing.