| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN EMPLOYEE BENEFITS | PO BOX 1064 BURLINGTON, VT 05402 | BLUE CROSS AND BLUE SHIELD OF VERMONT | $20K | $0 | $20K | 2.83% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FIN PLNG & GRP IN | 346 SHELBURNE ROAD PO BOX 1064 BURLINGTON, VT 054011064 | DELTA DENTAL PLAN OF VERMONT, INC. | $2K | $0 | $2K | 4.63% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 033021320 | DELTA DENTAL PLAN OF VERMONT, INC. | $405 | $0 | $405 | 0.76% |
| THOMAS D RUGG3 | PO BOX 1064 BURLINGTON, VT 05402 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 12.33% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FNCL SVCS | PO BOX 1064 BURLINGTON, VT 054021064 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $291 | $0 | $291 | 1.22% |
| THOMAS D RUGG3 | PO BOX 1064 BURLINGTON, VT 05402 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.27% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FNCL SVCS | PO BOX 1064 BURLINGTON, VT 054021064 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $242 | $0 | $242 | 1.23% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FNCL SVCS | PO BOX 1064 BURLINGTON, VT 054021064 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 11.13% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FIN PLNG GRP BNFT | PO BOX 1064 BURLINGTON, VT 054021064 | VISION SERVICE PLAN | $717 | $0 | $717 | 7.67% |
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 | 123 | 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) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF VERMONT | 145 | $703K |
| Dental | DELTA DENTAL PLAN OF VERMONT, INC. | 168 | $53K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF VERMONT | 145 | $712K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 115 | $16K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 115 | $20K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 113 | $24K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF VERMONT | 145 | $703K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 115 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 168 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.