| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLARK INSURANCE3 | PO BOX 3543 PORTLAND, ME 041040000 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $73K | $136 | $73K | 4.00% |
| CLARK INSURANCE3 | 1945 CONGRESS ST BLDG A PO BOX 3543 PORTLAND, ME 041043543 | DELTA DENTAL OF MAINE | $5K | — | $5K | 3.99% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE BEN | PO BOX 1320 CONCORD, NE 033021320 | DELTA DENTAL OF MAINE | $124 | — | $124 | 0.10% |
| CLARK INSURANCE3 | 2385 CONGRESS ST PO BOX 3543 PORTLAND, ME 04102 | CIGNA GROUP INSURANCE | $5K | — | $5K | 7.96% |
| CLARK INSURANCE3 | 2385 CONGRESS ST PO BOX 3543 PORTLAND, ME 04102 | CIGNA GROUP INSURANCE | $4K | — | $4K | 7.20% |
| CLARK INSURANCE3 | 2385 CONGRESS ST PO BOX 3543 PORTLAND, ME 04102 | CIGNA GROUP INSURANCE | $3K | — | $3K | 12.00% |
| CLARK INSURANCE3 | 1945 CONGRESS ST #A PORTLAND, ME 04102 | VISION SERVICE PLAN | $1K | — | $1K | 5.50% |
| CLARK INSURANCE3 | 2385 CONGRESS ST PO BOX 3543 PORTLAND, ME 04102 | CIGNA GROUP INSURANCE | $539 | — | $539 | 12.00% |
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 | 101 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 153 | $1.8M |
| Dental | DELTA DENTAL OF MAINE | 279 | $124K |
| Vision | VISION SERVICE PLAN | 145 | $20K |
| Life insurance | CIGNA GROUP INSURANCE | 101 | $25K |
| Short-term disability | CIGNA GROUP INSURANCE | 69 | $51K |
| Long-term disability | CIGNA GROUP INSURANCE | 58 | $59K |
| Other | CIGNA GROUP INSURANCE | 101 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 279 | — |
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.