| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | THREE EMBARCADERO CENTER, SUITE 600 SAN FRANCISCO, CA 94111 | ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. | $183K | — | $183K | 2.53% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | HARTFORD LIFE AND ACCIDENT | $84K | — | $84K | 15.63% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HARTFORD LIFE AND ACCIDENT | — | $20K | $20K | 3.71% |
| LOCKTON COMPANIES, LLC3 | 4725 PIEDMONT ROW DRIVE, SUITE 510 CHARLOTTE, NC 28210 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $6K | — | $6K | 1.66% |
| LOCKTON COMPANIES, LLC3 | 4725 PIEDMONT ROW DRIVE, SUITE 510 CHARLOTTE, NC 28210 | RED TREE INSURANCE COMPANY, INC. | $5K | — | $5K | 10.08% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 03302 | RED TREE INSURANCE COMPANY, INC. | $757 | — | $757 | 1.51% |
| PACIFIC BUSINESS SOLUTIONS, LLC3 Filed as: PACIFIC BUSINESS SOLUTIONS | PO BOX 240655 HONOLULU, HI 96824 | UNIVERSITY HEALTH ALLIANCE | $1K | — | $1K | 3.50% |
| LOCKTON COMPANIES, LLC3 | 76 BATTERSON PARK ROAD, 3RD FLOOR FARMINGTON, CT 06032 | LEGALPLANS, USA | — | $4K | $4K | 15.00% |
| RUBEN WARNER ASSOCIATES, INC.3 | 300 CONNELL DRIVE, SUITE 1100 BERKELEY HEIGHTS, NJ 07922 | HARTFORD LIFE AND ACCIDENT | $357 | $131 | $488 | 21.85% |
| LOCKTON COMPANIES, LLC3 | PO BOX 650823 DALLAS, TX 75265 | METROPOLITAN LIFE INSURANCE COMPANY | $157 | $271 | $428 | 53.97% |
| LOCKTON COMPANIES, LLC3 | PO BOX 650823 DALLAS, TX 75265 | METROPOLITAN LIFE INSURANCE COMPANY | $115 | $273 | $388 | 56.31% |
| LOCKTON COMPANIES, LLC3 | PO BOX 650823 DALLAS, TX 75265 | METROPOLITAN LIFE INSURANCE COMPANY | $24 | $190 | $214 | 109.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SURENCY LIFE & HEALTH INSURANCE EIN 26-1969006 ADMINISTRATOR | Contract Administrator Service code 13 | — | $38K |
| ANTHEM BLUE CROSS AND BLUE SHIELD EIN 02-0510530 ADMINISTRATOR | Contract Administrator Service code 13 | — | $6K |
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 | 999 | 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) | 999 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. | 1,005 | $7.2M |
| Dental(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. | 1,053 | $7.6M |
| Vision | RED TREE INSURANCE COMPANY, INC. | 890 | $50K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,334 | $535K |
| Short-term disability(2 contracts) | HARTFORD LIFE AND ACCIDENT | 1,334 | $537K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,334 | $535K |
| Prescription drug | UNIVERSITY HEALTH ALLIANCE | 4 | $34K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 1,334 | $564K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,334 | — |
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.