| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMBINED SERVICES LLC3 | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $673 | — | $673 | 1.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 505 FIFTH AVE SUITE 200 SEATTLE, WA 98104 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 14.42% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 505 FIFTH AVE SUITE 200 SEATTLE, WA 98104 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 11.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 505 FIFTH AVE SUITE 200 SEATTLE, WA 98104 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 505 FIFTH AVE SUITE 200 SEATTLE, WA 98104 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $343 | — | $343 | 10.71% |
| 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 | $405 | — | $405 | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 505 FIFTH AVE SUITE 200 SEATTLE, WA 98104 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $247 | — | $247 | 14.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 505 FIFTH AVE SUITE 200 SEATTLE, WA 98104 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $86 | — | $86 | 10.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 ADMINISTRATIVE | Other services; Participant communication; Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Contract Administrator; Named fiduciary Service code 12 | — | $47K |
| FRED C. CHURCH EIN 04-2445292 BROKER | Insurance agents and brokers Service code 22 | 41 WELLMAN STREET LOWELL, MA 01851 | $46K |
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 | 139 | 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) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | 144 | $56K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $10K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $52K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 71 | $13K |
| Other(3 contracts, 2 carriers) | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | 175 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.