| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MASSACHUSETTS INC | THREE COPLEY PLACE, STE 300 100 HUNTINGTON AVE BOSTON, MA 02116 | ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. | $27K | — | $27K | 3.70% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | 444 MARKET ST STE 1600 SAN FRANCISCO, CA 94111 | ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. | — | $735 | $735 | 0.10% |
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL OF NEW HAMPSHIRE, INC. | $932 | — | $932 | 1.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF SEATTLE, INC. | PO BOX 100252 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | $10K | — | $10K | 18.90% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | PO BOX 101162 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $752 | $752 | 1.39% |
| NEW ENGLAND EMPLOYEE BENEFITS CO3 | 15 CHENELL DRIVE CONCORD, NH 03301 | ANTHEM LIFE INSURANCE COMPANY | $700 | $289 | $989 | 20.92% |
| FRED C. CHURCH INC.3 Filed as: FRED C. CHURCH, INC. | 41 WELLMAN STREET LOWELL, MA 01851 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $143 | — | $143 | 15.05% |
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 | 162 | 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) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. | 101 | $1.2M |
| Dental | DELTA DENTAL OF NEW HAMPSHIRE, INC. | 166 | $78K |
| Vision | ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. | 101 | $737K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 162 | $59K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 77 | $54K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 77 | $54K |
| Other(4 contracts, 4 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 162 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.