| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. | $167K | — | $167K | 4.50% |
| LOCKTON COMPANIES, LLC3 | 4725 PIEDMONT ROW DRIVE, SUITE 510 CHARLOTTE, NC 28210 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $7K | — | $7K | 2.18% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $2K | — | $2K | 0.52% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $2K | $18K | 17.00% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $1K | $12K | 17.00% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $1K | $7K | 11.75% |
| LOCKTON COMPANIES, LLC3 | 4725 PIEDMONT ROW DRIVE, SUITE 510 CHARLOTTE, NC 28210 | RED TREE INSURANCE COMPANY, INC. | $4K | — | $4K | 10.09% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 03302 | RED TREE INSURANCE COMPANY, INC. | $567 | — | $567 | 1.51% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $391 | — | $391 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DISCOVERY BENEFITS EIN 90-0058554 ADMINISTRATOR | Contract Administrator Service code 13 | — | $40K |
| NEW DIRECTIONS BEHAVIORAL HEALTH EIN 43-1698690 ADMINISTRATOR | Contract Administrator Service code 13 | — | $12K |
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 | 871 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 888 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. | 570 | $4.8M |
| Dental | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | 776 | $302K |
| Vision | RED TREE INSURANCE COMPANY, INC. | 687 | $37K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 871 | $60K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 287 | $104K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 871 | $60K |
| Prescription drug | UNIVERSITY HEALTH ALLIANCE | 11 | $108K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 871 | $134K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 871 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.