| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOLDEN AGENCY3 Filed as: THE HOLDEN AGENCY | 1085 BRIGHTON AVE, PO BOX 10610 PORTLAND, ME 04104 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $51K | — | $51K | 21.90% |
| HOLDEN AGENCY3 Filed as: THE HOLDEN AGENCY | 1085 BRIGHTON AVE, PO BOX 10610 PORTLAND, ME 04104 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 7.50% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE STE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $77 | $77 | 0.06% |
| HOLDEN AGENCY3 Filed as: THE HOLDEN AGENCY | 1085 BRIGHTON AVE, PO BOX 10610 PORTLAND, ME 04104 | DELTA DENTAL PLAN OF MAINE | $4K | — | $4K | 4.16% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 033021320 | DELTA DENTAL PLAN OF MAINE | $983 | — | $983 | 1.05% |
| NANCY DROUIN3 | PO BOX 137 STEEP FALLS, ME 04085 | AFLAC | $3K | $107 | $3K | 10.52% |
| ROBERT R KURTZ3 Filed as: ROBERT KURTZ | PO BOX 3494 LEWISTON, ME 04243 | AFLAC | $474 | $18 | $492 | 1.72% |
| BARBARA TORRES3 | 20 HOBBS RD EFFINGHAM, NH 03882 | AFLAC | $219 | — | $219 | 0.76% |
| SCOTT HUNTLEY3 Filed as: SCOTT MCCOY | 108 STATE STREET, SUITE 1 BANGOR, ME 04401 | AFLAC | $184 | $7 | $191 | 0.67% |
| MAYNARD M. YOUNG3 Filed as: MAYNARD YOUNG | 20 HOBBS RD EFFINGHAM, NH 03882 | AFLAC | $179 | — | $179 | 0.62% |
| JAMES BERGDOLL3 | 135 LASSELLE RD BURNHAM, ME 04922 | AFLAC | $141 | — | $141 | 0.49% |
| CRYSTAL YOUNG3 | 113 SOUTH PRAIRIE AVE PUEBLO, CO 81005 | AFLAC | $136 | — | $136 | 0.47% |
| WILLIAM HENRY3 | ONE SUNDIAL AVE, SUITE 212N MANCHESTER, NH 03103 | AFLAC | $106 | $18 | $124 | 0.43% |
| ROBERT R KURTZ3 Filed as: ROBERT KURTZ | 306 BEECH HILL RD AUBURN, ME 04210 | AFLAC | $83 | $3 | $86 | 0.30% |
| WILLIAM HENRY3 | 182 PROSPECT ST, 1ST FLR MANCHESTER, NH 03104 | AFLAC | $68 | $3 | $71 | 0.25% |
| KATTY W COHEN3 Filed as: KATTY COHEN | 21711 TOWN PLACE DRIVE BOCA RATON, FL 33433 | AFLAC | $68 | — | $68 | 0.24% |
| JAMES (JAY) GRIMES3 Filed as: JAMES GRIMES | 4272 PERSIMMON WOODS DR NORTH CHARLESTON, SC 29420 | AFLAC | $63 | — | $63 | 0.22% |
| ELAINE C HANSON3 Filed as: ELAINE HANSON | 30 CUSHNOC ROAD VASSALBORO, ME 04989 | AFLAC | $50 | $12 | $62 | 0.22% |
| JAKE ENTERPRISES INC3 | 25 LOCKLAND DRIVE, PO BOX 1977 WINDHAM, ME 04062 | AFLAC | $31 | — | $31 | 0.11% |
| MARCEL RICHARD MORIN3 | 6907 W GRACE ST RICHMOND, VA 23226 | AFLAC | $26 | $3 | $29 | 0.10% |
| WALTER TOLSON3 | 104 SHELLEY LN FORT PIERCE, FL 34949 | AFLAC | $16 | — | $16 | 0.06% |
| BOBBY DELIDLE3 | 76 OLD POINT AVE MADISON, ME 04950 | AFLAC | $14 | — | $14 | 0.05% |
| NATHANIEL PARKINSON II3 | 355 SANBORN RD MONMOUTH, ME 04259 | AFLAC | $12 | — | $12 | 0.04% |
| KENDALL C HUDSON3 Filed as: KENDALL HUDSON | 801 NORTHPOINT PARKWAY STE 35 WEST PALM BEACH, FL 33407 | AFLAC | $6 | — | $6 | 0.02% |
| JOHN WALSH3 | 306 CENTER RD FAIRFIELD, ME 04937 | AFLAC | $2 | — | $2 | 0.01% |
| C HUDSON AND ASSOCIATES3 | 2843 TWIN PINE RD THOMSON, GA 30824 | AFLAC | $2 | — | $2 | 0.01% |
| MELISSA NELSON3 | 28 ARIEL STREET LINCOLN, ME 04457 | AFLAC | $1 | — | $1 | 0.00% |
| J W GRIMES INC3 Filed as: JW GRIMES INC | 7659 HERITAGE CROSSING WAY REUNION, FL 34747 | AFLAC | $1 | — | $1 | 0.00% |
| HOLDEN AGENCY3 Filed as: THE HOLDEN AGENCY | 1085 BRIGHTON AVE, PO BOX 10610 PORTLAND, ME 04104 | VISION SERVICE PLAN | $937 | — | $937 | 6.15% |
| HOLDEN AGENCY3 Filed as: THE HOLDEN AGENCY | 1085 BRIGHTON AVE, PO BOX 10610 PORTLAND, ME 04104 | GERBER LIFE & ACCIDENT INSURANCE COMPANY | $181 | — | $181 | 15.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 MEDICAL ADMINISTRATOR | Contract Administrator Service code 13 | — | $66K |
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 | 178 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 215 | $235K |
| Dental | DELTA DENTAL PLAN OF MAINE | 270 | $93K |
| Vision | VISION SERVICE PLAN | 116 | $15K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 210 | $120K |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 210 | $148K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 210 | $120K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 250 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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.