| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | HARVARD PILGRIM HEALTH CARE | $43K | $3K | $46K | 2.01% |
| USI INSURANCE SERVICES LLC3 | 75 JOHN ROBERTS ROAD, BUILDING C SOUTH PORTLAND, ME 04106 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $7K | $18K | 11.37% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | DELTA DENTAL PLAN OF MAINE | $4K | $0 | $4K | 4.33% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | RED TREE INSURANCE COMPANY, INC | $1K | $0 | $1K | 9.87% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 03302 | RED TREE INSURANCE COMPANY, INC | $165 | $0 | $165 | 1.48% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | HPHC INSURANCE COMPANY | $337 | $24 | $361 | 3.97% |
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 | 193 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 166 | $2.3M |
| Dental | DELTA DENTAL PLAN OF MAINE | 263 | $97K |
| Vision | RED TREE INSURANCE COMPANY, INC | 263 | $11K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 312 | $160K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 312 | $160K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 312 | $160K |
| Prescription drug(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE | 166 | $2.3M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 312 | $160K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 312 | — |
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.