| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS DESIGN, INC.3 | 424 STRICKLAND ROAD FORT FAIRFIELD, ME 04742 | ANTHEM HEALTH PLANS OF MAINE, INC. | $9K | $4K | $13K | 14.23% |
| EMPLOYEE BENEFITS DESIGN, INC.3 | 424 STRICKLAND ROAD FORT FAIRFIELD, ME 04742 | METLIFE | $2K | — | $2K | 2.82% |
| EMPLOYEE BENEFITS DESIGN, INC.3 | 424 STRICKLAND ROAD FORT FAIRFIELD, ME 04742 | RELIASTAR LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| EMPLOYEE BENEFITS DESIGN, INC.3 | 424 STRICKLAND ROAD FORT FAIRFIELD, ME 04742 | VISION SERVICE PLAN | $0 | — | $0 | 0.00% |
| EMPLOYEE BENEFITS DESIGN, INC.3 | 424 STRICKLAND ROAD FORT FAIRFIELD, MA 04742 | CIGNA LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| EMPLOYEE BENEFITS DESIGN, INC.3 | 424 STRICKLAND ROAD FORT FAIRFIELD, ME 04742 | CIGNA GROUP INSURANCE | $0 | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF MAINE INC. EIN 31-1705652 MED ASO ADMINISTRATOR | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Other services Service code 12 | — | $116K |
| CIGNA LIFE INSURANCE COMPANY EIN 23-1503749 STD ASO ADMINISTRATOR | Claims processing Service code 12 | — | $3K |
| EMPLOYEE BENEFITS DESING, INC. EIN 01-0467041 BROKER | Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | — | $0 |
| EXPRESS SCRIPTS, INC. EIN 31-1714795 RX DRUG ADMINISTRATOR | Claims processing; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $0 |
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 | 192 | 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) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METLIFE | 437 | $71K |
| Vision | VISION SERVICE PLAN | 174 | $15K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 192 | $43K |
| Long-term disability(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE COMPANY | 147 | $10K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF MAINE, INC. | 181 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 437 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.