| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KYES AGENCY, INC.3 Filed as: KYES AGENCY INC. | 171 MAIN ST. FARMINGTON, ME 04938 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $43K | — | $43K | 9.78% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 1 FOREST PARK DRIVE FARMINGTON, CT 06032 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $31K | $31K | 7.12% |
| C M SMITH AGENCY, INC.3 Filed as: CM SMITH AGENCY, INC. | 100 PEARL STREET HARTFORD, CT 06106 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $14K | — | $14K | 3.30% |
| KYES AGENCY, INC.3 Filed as: THE KYES AGENCY INC. | 171 MAIN STREET FARMINGTON, ME 04938 | AMERITAS LIFE INSURANCE CORP | $1K | $186 | $1K | 5.30% |
| C M SMITH AGENCY, INC.3 | 100 PEARL STREET FL 3 WEST TOWER HARTFORD, CT 06103 | AMERITAS LIFE INSURANCE CORP | $191 | — | $191 | 0.68% |
| KYES AGENCY, INC.3 Filed as: THE KYES AGENCY INC. | 171 MAIN STREET FARMINGTON, ME 04938 | AMERITAS LIFE INSURANCE CORP | $1K | $152 | $2K | 6.41% |
| C M SMITH AGENCY, INC.3 Filed as: C M SMITH AGENCY INC. | 100 PEARL STREET 3RD FL WEST TOWER HARTFORD, CT 06103 | AMERITAS LIFE INSURANCE CORP | $131 | — | $131 | 0.53% |
| TERRY L GUNZINGER3 | PO BOX 311 FARMINGTON, ME 04938 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 7.43% |
| C M SMITH AGENCY, INC.3 Filed as: C M SMITH AGENCY LLC | 100 PEARL ST. 3RD FL WEST TOWER HARTFORD, CT 06103 | SUN LIFE ASSURANCE COMPANY OF CANADA | $568 | — | $568 | 2.34% |
| KYES AGENCY, INC.3 Filed as: KYES AGENCY | 171 MAIN ST PO BOX 311 FARMINGTON, ME 04938 | HARVARD PILGRIM HEALTH CARE | $670 | — | $670 | 2.97% |
| C M SMITH AGENCY, INC.3 Filed as: C M SMITH AGENCY INC. | 100 PEARL ST. 3RD FL WEST TOWER HARTFORD, CT 06103 | HARVARD PILGRIM HEALTH CARE | $71 | — | $71 | 0.31% |
| KYES AGENCY, INC.3 Filed as: THE KYES AGENCY INC. | 171 MAIN STREET FARMINGTON, ME 04938 | AMERITAS LIFE INSURANCE CORP | $860 | $85 | $945 | 4.88% |
| C M SMITH AGENCY, INC.3 Filed as: C M SMITH AGENCY INC. | 100 PEARL STREET 3RD FL WEST TOWER HARTFORD, CT 06103 | AMERITAS LIFE INSURANCE CORP | $108 | — | $108 | 0.56% |
| ACADIA BENEFITS INC3 Filed as: ACADIA BENEFITS INC. | 111 COMMERCIAL ST. 5TH FL PORTLAND, ME 04101 | DELTA DENTAL PLAN OF MAINE | $236 | — | $236 | 2.39% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA | CSONE BENEFIT SOLUTIONS PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF MAINE | $58 | — | $58 | 0.59% |
| KYES AGENCY, INC.3 Filed as: THE KYES AGENCY INC. | PO BOX 311 171 MAIN STREET FARMINGTON, ME 04938 | DEARBORN LIFE INSURANCE COMPANY | $622 | — | $622 | 6.70% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 03302 | DEARBORN LIFE INSURANCE COMPANY | — | $473 | $473 | 5.10% |
| C M SMITH AGENCY, INC.3 Filed as: C M SMITH AGENCY LLC | 100 PEARL STREET HARTFORD, CT 06103 | DEARBORN LIFE INSURANCE COMPANY | $167 | — | $167 | 1.80% |
| KYES AGENCY, INC.3 Filed as: THE KYES AGENCY INC. | PO BOX 311 171 MAIN STREET FARMINGTON, ME 04938 | DEARBORN LIFE INSURANCE COMPANY | $268 | — | $268 | 14.35% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 03302 | DEARBORN LIFE INSURANCE COMPANY | — | $183 | $183 | 9.80% |
| C M SMITH AGENCY, INC.3 Filed as: C M SMITH AGENCY LLC | 100 PEARL STREET HARTFORD, CT 06106 | DEARBORN LIFE INSURANCE COMPANY | $98 | — | $98 | 5.25% |
| KYES AGENCY, INC.3 Filed as: KYES AGENCY | 171 MAIN STREET PO BOX 311 FARMINGTON, ME 04938 | HPHC INSURANCE COMPANY | $25 | — | $25 | 2.91% |
| C M SMITH AGENCY, INC.3 Filed as: C M SMITH AGENCY | 100 PEARL STREET 3RD FL WEST TOWER HARTFORD, CT 06103 | HPHC INSURANCE COMPANY | $3 | — | $3 | 0.35% |
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 | 214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 219 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 214 | $460K |
| Dental(4 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP | 83 | $82K |
| Vision(2 contracts) | AMERITAS LIFE INSURANCE CORP | 83 | $53K |
| Life insurance(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 37 | $35K |
| Short-term disability(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 37 | $35K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 33 | $24K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 37 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.