| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 3 EXECUTIVE PARK DRIVE, SUITE 300 BEDFORD, NH 03110 | HARVARD PILGRIM HEALTH CARE OF NE INC | $35K | $0 | $35K | 2.87% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $6K | $0 | $6K | 5.45% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $951 | $0 | $951 | 0.89% |
| USI INSURANCE SERVICES LLC3 | 3 EXECUTIVE PARK DRIVE, SUITE 300 BEDFORD, NH 03110 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $9K | 18.96% |
| USI INSURANCE SERVICES LLC3 | 3 EXECUTIVE PARK DRIVE, SUITE 300 BEDFORD, NH 03110 | HPHC INSURANCE COMPANY | $356 | $0 | $356 | 2.76% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | RED TREE INSURANCE COMPANY, INC. | $742 | $0 | $742 | 10.26% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 03302 | RED TREE INSURANCE COMPANY, INC. | $111 | $0 | $111 | 1.53% |
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 | 113 | 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) | 113 | 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 | 207 | $1.2M |
| Dental | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | 204 | $106K |
| Vision | RED TREE INSURANCE COMPANY, INC. | 116 | $7K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 113 | $45K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 113 | $45K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 113 | $45K |
| Prescription drug(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE OF NE INC | 207 | $1.2M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 113 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 207 | — |
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.