| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER AND SHEPLEY INC | 60 CATAMORE BOULEVARD EAST PROVIDENCE, RI 02901 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $2K | $28K | $30K | 1.44% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY INSURANCE BR | PO BOX 549 PROVIDENCE, RI 02901 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $954 | — | $954 | 3.18% |
| J KING INSURANCE INC3 | 50 MAIN STREET EAST GREENWICH, RI 02818 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $499 | $34 | $533 | 1.78% |
| LAURIE SEUBERT3 | 50 MAIN STREET EAST GREENWICH, RI 02818 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $225 | $3 | $228 | 0.76% |
| THERESA CATHERINE MACMILLAN3 | 650 EAST GREENWICH AVENUE WEST WARWICK, RI 02893 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $185 | $1 | $186 | 0.62% |
| JAMES R SMITH INSURANCE LTD3 | 333 MAIN STREET EAST GREENWICH, RI 02818 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $173 | $8 | $181 | 0.60% |
| CYNTHIA SUSANNE EVERY3 | 212 WEST DUNCAN MANCHESTER, MI 48158 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $1 | $28 | 0.09% |
| JEREMY SAMPSEL3 | 401 HALL STREET SOUTHWEST GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $3 | $5 | 0.02% |
| BEIYANIL E PENA3 | 115 POCASSET AVENUE PROVIDENCE, RI 02909 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY IN | PO BOX 549 PROVIDENCE, RI 02901 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 8.86% |
| STARKWEATHER & SHEPLEY, INC.3 | PO BOX 549 PROVIDENCE, RI 02901 | VISION SERVICE PLAN | $460 | — | $460 | 3.10% |
| J KING INSURANCE INC3 Filed as: J. KING INSURANCE, INC. | 333 MAIN STREET SUITE 1 EAST GREENWICH, RI 02818 | VISION SERVICE PLAN | $460 | — | $460 | 3.10% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY IN | PO BOX 549 PROVIDENCE, RI 02901 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $968 | — | $968 | 16.52% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY IN | PO BOX 549 PROVIDENCE, RI 02901 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $428 | — | $428 | 17.98% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY IN | PO BOX 549 PROVIDENCE, RI 02901 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $53 | — | $53 | 14.89% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY IN | PO BOX 549 PROVIDENCE, RI 02901 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15 | — | $15 | 10.27% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY IN | PO BOX 549 PROVIDENCE, RI 02901 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14 | — | $14 | — |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY IN | PO BOX 549 PROVIDENCE, RI 02901 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$3 | — | -$3 | — |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY IN | PO BOX 549 PROVIDENCE, RI 02901 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$6 | — | -$6 | — |
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 | 179 | 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) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 160 | $2.1M |
| Vision | VISION SERVICE PLAN | 88 | $15K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 180 | $57K |
| Short-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3 | $502 |
| Long-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 17 | $6K |
| Other(6 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 191 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 191 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.