| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS INSURANCE3 Filed as: CROSS INSURANCE, INC. | PO BOX 1388 BANGOR, ME 04402 | DENTAL SERVICE OF MASSACHUSETTS, INC DBA DELTA DENTAL | $3K | — | $3K | 5.01% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE, INC. | PO BOX 1388 BANGOR, ME 04402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 22.93% |
| CROSS INSURANCE3 | 491 MAIN STREET BANGOR, ME 04401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 7.62% |
| FIAI INC3 Filed as: FIAI, INC. | 1100 ELM STREET MANCHESTER, NH 03101 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. | $1K | — | $1K | 11.01% |
| CROSS INSURANCE3 | 1100 ELM STREET MANCHESTER, NH 03101 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. | $133 | — | $133 | 1.08% |
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 | 172 | 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) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC DBA DELTA DENTAL | 4 | $59K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. CO. | 5 | $12K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $20K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $20K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $20K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.