| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PGIA, INC.3 Filed as: PGIA, INC. DBA PROVIDER INSUARANCE | PO BOX 1388 BANGOR, ME 04401 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $4K | $30K | $34K | 1.90% |
| PGIA, INC DBA PROVIDER INSURANCE3 | 160 GOULD STREET SUITE 122 NEEDHAM, MA 02494 | DELTA DENTAL OF RHODE ISLAND | $4K | — | $4K | 3.26% |
| JOHN GAUTREAUX3 | 935 JEFFERSON BOULEVARD SUITE 2000 WARWICK, RI 02886 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 8.62% |
| KAREN SUE DARCY3 | 31 HARMONY CROSSING EAST BRIDGEWATER, MA 02333 | AFLAC | $827 | — | $827 | 2.72% |
| BRADFORD M LYTTLE3 | PO BOX 1461 PEMBROKE, MA 02359 | AFLAC | $323 | — | $323 | 1.06% |
| KATHLEEN V LOOPER3 | 251 PARKER ROAD SUCHES, GA 30572 | AFLAC | $305 | — | $305 | 1.00% |
| DIANA N MARTINEZ3 | 14016 NORTH LAKE BRANCH LANE HOUSTON, TX 77044 | AFLAC | $235 | — | $235 | 0.77% |
| JAMES E VOGELAAR3 Filed as: JAMES J DUPLESSIS | 601 HENRY LANDRY AVENUE METAIRIE, LA 70006 | AFLAC | $205 | — | $205 | 0.67% |
| KAREN TUCCI3 | 73 STETSON DRIVE MARLBOROUGH, MA 01752 | AFLAC | $140 | — | $140 | 0.46% |
| MICHAEL A CUTAIA3 | 13883 KIDD ROAD CONROE, TX 77302 | AFLAC | $138 | — | $138 | 0.45% |
| SCOTT C MARTINA3 | 4924 CLEVELAND PLACE METAIRIE, LA 70003 | AFLAC | $113 | — | $113 | 0.37% |
| MARY E HUCKABEE3 | 1510 RIVERVEND CROSSING SUGAR LAND, TX 77478 | AFLAC | $98 | — | $98 | 0.32% |
| DANIEL P CLARK3 | 33 LANDAU ROAD PLAINVILLE, MA 02762 | AFLAC | $84 | — | $84 | 0.28% |
| LAURA N TORRES3 | PO BOX 12373 BEAUMONT, TX 77726 | AFLAC | $76 | — | $76 | 0.25% |
| KEVIN J NIEDERAUER3 | 22 NASHAWAY DRIVE RINGOES, NJ 08551 | AFLAC | $70 | — | $70 | 0.23% |
| LAWRENCE T MATES3 | 925 ORONOKE ROAD UNIT 24F WATERBURY, CT 06708 | AFLAC | $70 | — | $70 | 0.23% |
| JARED E DAY3 | 19710 CHARA COURT CYPRESS, TX 77433 | AFLAC | $64 | — | $64 | 0.21% |
| ELLIS G HASSIEN3 | PO BOX 1448 SULPHUR, LA 70664 | AFLAC | $54 | — | $54 | 0.18% |
| BRYAN J DODGE3 | 804 LYONS STREET NEW ORLEANS, LA 70115 | AFLAC | $51 | — | $51 | 0.17% |
| MICHAEL SCOTT ENOS3 | 1602 RUELLE DE GRACE DRIVE BATON ROUGE, LA 70810 | AFLAC | $45 | — | $45 | 0.15% |
| MICHAEL GRASS3 | 21707 KINGSLAND BOULEVARD SUITE 105 KATY, TX 77450 | AFLAC | $38 | — | $38 | 0.12% |
| RICHARD DACEY3 | 51 EAST VALLEY BROOK ROAD LONG VALLEY, NJ 07853 | AFLAC | $35 | — | $35 | 0.12% |
| EDWARD L MARTINA JR3 | 4101 LAKE TRAIL DRIVE KENNER, LA 70065 | AFLAC | $32 | — | $32 | 0.11% |
| DANA M SCHMANSKI3 | 23302 PRESERVE VIEW CIRCLE SPRING, TX 77389 | AFLAC | $31 | — | $31 | 0.10% |
| DYLAN FRANCIS MONTEFORTE3 | 13 EAGLE NEST ROAD COLTS NECK, NJ 07722 | AFLAC | $26 | — | $26 | 0.09% |
| KEVIN BARRY TURK3 | 7803 TWIN HILLS DRIVE HOUSTON, TX 77071 | AFLAC | $21 | — | $21 | 0.07% |
| KAREN J MCDONALD3 | 1008 GENE DRIVE LUMBERTON, TX 77657 | AFLAC | $21 | — | $21 | 0.07% |
| MAUREEN E SNOW3 | 68 WINGATE ROAD HOLLISTON, MA 01746 | AFLAC | $21 | — | $21 | 0.07% |
| ISABELLA L PARKER3 | 161 ANNAS LANE ZAVALLA, TX 75980 | AFLAC | $20 | — | $20 | 0.07% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN A PITUCH | PO BOX 335 SPARTA, NJ 07871 | AFLAC | $18 | — | $18 | 0.06% |
| PETER K HUYNH3 | 1705 WIPPRECHT STREET HOUSTON, TX 77020 | AFLAC | $16 | — | $16 | 0.05% |
| ERIC D WESTALL3 | 1207 TANGLE BRIAR DRIVE SEABROOK, TX 77586 | AFLAC | $15 | — | $15 | 0.05% |
| MICHAEL P ZILINSKI3 | 1633 WASHINGTON BOULEVARD APARTMENT 4E STAMFORD, CT 06902 | AFLAC | $15 | — | $15 | 0.05% |
| BRUCE G HILLYER3 | 8 HARVARD DRIVE CARMEL, NY 10512 | AFLAC | $13 | — | $13 | 0.04% |
| ST THERESE MARKETING INC3 | 4101 LAKE TRAIL DRIVE KENNER, LA 70065 | AFLAC | $13 | — | $13 | 0.04% |
| JOSHUA PAUL GROUP INC3 | 17 OAK LANE RANDOLPH, NJ 07869 | AFLAC | $12 | — | $12 | 0.04% |
| CRUSER MARKETING INC3 | 7516 BLUEBONNET BOULEVARD 116 BATON ROUGE, LA 70810 | AFLAC | $10 | — | $10 | 0.03% |
| KIMBERLY FERGUSON3 Filed as: KIMBERLY SANKA | 861 VOORHEES AVENUE MIDDLESEX, NJ 08846 | AFLAC | $8 | — | $8 | 0.03% |
| KEITH WILLIAM BELLE3 | 302 LA RUE FRANCE SUITE 100 LAFAYETTE, LA 70508 | AFLAC | $8 | — | $8 | 0.03% |
| SHAW ASSOCIATES INC3 | 11 JOY LANE READING, MA 01867 | AFLAC | $8 | — | $8 | 0.03% |
| ERROL B WILKEN3 | 5204 CRAIG AVENUE KENNER, LA 70065 | AFLAC | $7 | — | $7 | 0.02% |
| ALBERT SHUST3 | 200 CENTENNIAL AVENUE SUITE 105 PISCATAWAY, NJ 08854 | AFLAC | $6 | — | $6 | 0.02% |
| EDWARD L MARTINA III3 | 100 GENNA LANE YOUNGSVILLE, LA 70592 | AFLAC | $6 | — | $6 | 0.02% |
| MICHAEL GRASS3 | 21707 KINGSLAND BOULEVARD SUITE 105 KATY, TX 77450 | AFLAC | $5 | — | $5 | 0.02% |
| OLIVETTE B LEWIS3 | PO BOX 6127 NEW ORLEANS, LA 70174 | AFLAC | $4 | — | $4 | 0.01% |
| NATHAN A HUMMER3 | 5 WEBBER ROAD WESTFORD, MA 01886 | AFLAC | $4 | — | $4 | 0.01% |
| ERIN RADA3 Filed as: ERIN K RADA | 173 RAINBOW DRIVE # 7300 LIVINGSTON, TX 77399 | AFLAC | $4 | — | $4 | 0.01% |
| LOUIS R FAIOLA3 | 12 HAAWK COURT DELMAR, NY 12054 | AFLAC | $3 | — | $3 | 0.01% |
| JILL SCIRPO3 | 6 WILLETT POND ROAD WESTWOOD, MA 02090 | AFLAC | $3 | — | $3 | 0.01% |
| MICHAEL ANDERS LLC3 | 10 MOON BEAM COURT SPRING, TX 77381 | AFLAC | $3 | — | $3 | 0.01% |
| JEFF MUSGROVE3 | 31300 STONEBRIDGE PARKWAY WALLER, TX 77484 | AFLAC | $2 | — | $2 | 0.01% |
| TODD A STULL3 | 3000 EAST DIVISION STREET SUITE A SPRINGFIELD, MO 65802 | AFLAC | $2 | — | $2 | 0.01% |
| JEREMIAH TROY TALTON3 | 172 BIENVILLE DRIVE MADISON, MS 39110 | AFLAC | $2 | — | $2 | 0.01% |
| MICHAEL A FORNARO3 | 271 US HIGHWAY 46 SUITE H119 FAIRFIELD, NJ 07004 | AFLAC | $2 | — | $2 | 0.01% |
| CHERISE M WADE3 | 616 HARDEMAN STREET SEALY, TX 77474 | AFLAC | $2 | — | $2 | 0.01% |
| KIM REED SMITH3 | 7815 DEERWOOD LAKE DRIVE HUMBLE, TX 77346 | AFLAC | $2 | — | $2 | 0.01% |
| MAEDE C MILLER3 | 17133 KNOLL DALE TRAIL CONROE, TX 77385 | AFLAC | $2 | — | $2 | 0.01% |
| PRENTIS ATKINS CASTLE JR3 | 7293 DABADIE ROAD VENTRESS, LA 70783 | AFLAC | $2 | — | $2 | 0.01% |
| REY ROSTAMI3 | PO BOX 625 STOCKHOLM, NJ 07460 | AFLAC | $1 | — | $1 | 0.00% |
| TARA MICHELLE D AGOSTINO3 | 87A BOORAEM AVENUE JERSEY CITY, NJ 07307 | AFLAC | $1 | — | $1 | 0.00% |
| ERIC J LEGER3 | 623 EAST 7TH 1/2 STREET HOUSTON, TX 77007 | AFLAC | $1 | — | $1 | 0.00% |
| ROBERT JAMES LAMB3 | 53 RIDGEWOOD DRIVE STOW, MA 01775 | AFLAC | $1 | — | $1 | 0.00% |
| TIMOTHY MCDERMOTT3 | 29 MAPLE LANE MT ARLINGTON, NJ 07856 | AFLAC | $1 | — | $1 | 0.00% |
| BRIAN M LEYPOLDT3 | 67 ALLISON PLACE EGG HARBOR TOWNSHIP, NJ 08234 | AFLAC | $1 | — | $1 | 0.00% |
| JOHN GAUTREAUX3 | 935 JEFFERSON BOULEVARD SUITE 2000 WARWICK, RI 02886 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 13.38% |
| JOHN GAUTREAUX3 | 935 JEFFERSON BOULEVARD SUITE 2000 WARWICK, RI 02886 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| JOHN GAUTREAUX3 | 935 JEFFERSON BOULEVARD SUITE 2000 WARWICK, RI 02886 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $269 | — | $269 | 15.00% |
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 | 111 | 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) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 84 | $1.8M |
| Dental | DELTA DENTAL OF RHODE ISLAND | 211 | $111K |
| Vision | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 76 | $7K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 111 | $32K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 69 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 111 | $20K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 111 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 211 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.