| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE #2 AUGUSTA, ME 04330 | ANTHEM HEALTH PLANS OF MAINE | $2K | $139 | $2K | 0.26% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE #2 AUGUSTA, ME 04330 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 7.55% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE #2 AUGUSTA, ME 04330 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 9.86% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE #2 AUGUSTA, ME 04330 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 7.72% |
| CROSS INSURANCE3 | 116 COMMUNITY DRIVE #2 AUGUSTA, ME 04330 | CIGNA | $910 | — | $910 | 10.00% |
| BUSINESS INSURANCE AGENCY Filed as: BUSINESS INSURANCE AGENCY INC. | — | CIGNA | $910 | — | $910 | 10.00% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DRIVE #2 AUGUSTA, ME 04330 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $818 | — | $818 | 12.46% |
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 | 159 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF MAINE | 134 | $720K |
| Vision | ANTHEM HEALTH PLANS OF MAINE | 134 | $720K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $45K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $39K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $43K |
| Prescription drug | ANTHEM HEALTH PLANS OF MAINE | 134 | $720K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF MAINE | 134 | $720K |
| Other(3 contracts, 2 carriers) | CIGNA | 159 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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.