| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PL, 14TH FL ITASCA, IL 60143 | HARVARD PILGRIM HEALTH CARE OF NE INC. - MA | $18K | $0 | $18K | 2.94% |
| CGI EMPLOYEE BENEFITS GROUP3 | 171 LONDONDERRY TPKE HOOKSETT, NH 031061977 | HARVARD PILGRIM HEALTH CARE OF NE INC. - MA | $6K | $0 | $6K | 1.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | HARVARD PILGRIM HEALTH CARE OF NE, INC. - MA | $5K | $0 | $5K | 2.94% |
| CGI EMPLOYEE BENEFITS GROUP3 | 171 LONDONDERRY TPKE HOOKSETT, NH 031061977 | HARVARD PILGRIM HEALTH CARE OF NE, INC. - MA | $2K | $0 | $2K | 1.05% |
| E&S INSURANCE SERVICES LLC3 Filed as: E AND S INSURANCE SERVICES, LLC | PO BOX 7425 GILFORD, NH 032477425 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $3K | $0 | $3K | 6.76% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 033021320 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $206 | $0 | $206 | 0.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | STANDARD INSURANCE COMPANY | $3K | $0 | $3K | 13.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 650 E CARMEL DRIVE SUITE 400 CARMEL, IN 46032 | MATTHEW THORNTON HEALTH PLAN, INC. | $8K | $0 | $8K | — |
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 | 145 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE OF NE INC. - MA | 134 | $599K |
| Dental | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | 86 | $48K |
| Life insurance | STANDARD INSURANCE COMPANY | 145 | $19K |
| Short-term disability | STANDARD INSURANCE COMPANY | 145 | $19K |
| Long-term disability | STANDARD INSURANCE COMPANY | 145 | $19K |
| Prescription drug(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE OF NE INC. - MA | 134 | $599K |
| Other | STANDARD INSURANCE COMPANY | 145 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 145 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.