| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE 240 CRANSTON, RI 02920 | HCC LIFE INSURANCE COMPANY | — | $4K | $4K | 0.90% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | ALTUS DENTAL INSURANCE COMPANY, INC. | $6K | — | $6K | 5.00% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | METLIFE | $9K | — | $9K | 16.74% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | EYEMED VISION CARE | $2K | — | $2K | 10.00% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 24.27% |
| PAYCOR INC3 Filed as: PAYCOR INC. | PO BOX 639860 CINCINNATI, OH 45263 | STANDARD INSURANCE COMPANY | — | $242 | $242 | 4.85% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | STANDARD INSURANCE COMPANY | $226 | — | $226 | 11.98% |
| PAYCOR INC3 Filed as: PAYCOR INC. | PO BOX 639860 CINCINNATI, OH 45263 | STANDARD INSURANCE COMPANY | — | $34 | $34 | 1.80% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | STANDARD INSURANCE COMPANY | $187 | — | $187 | 15.01% |
| PAYCOR INC3 Filed as: PAYCOR INC. | PO BOX 639860 CINCINNATI, OH 45263 | STANDARD INSURANCE COMPANY | — | $37 | $37 | 2.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE BENEFIT ADMINISTRATORS OF MA THIRD PARTY ADMINISTRATO | Claims processing; Contract Administrator Service code 12 | PO BOX 55917 BOSTON, MA 02205 | $88K |
| HILB GROUP OF NEW ENGLAND BROKER | Insurance agents and brokers; Other commissions Service code 22 | 2000 CHAPEL VIEW BLVD., STE 240 CRANSTON, RI 02920 | $36K |
| RXBENEFITS, INC. EIN 63-1157085 THIRD PARTY ADMINISTRATO | Contract Administrator; Claims processing Service code 12 | — | $2K |
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 | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | ALTUS DENTAL INSURANCE COMPANY, INC. | 240 | $117K |
| Vision | EYEMED VISION CARE | 217 | $18K |
| Life insurance(2 contracts, 2 carriers) | METLIFE | 162 | $54K |
| Long-term disability(2 contracts, 2 carriers) | METLIFE | 162 | $58K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 118 | $411K |
| Other | METLIFE | 162 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 240 | — |
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."
No prospect flags tripped on this filing.