| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 50 BRAINTREE HILL OFFICE PARK BRAINTREE, MA 02184 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $1K | $25K | $27K | 1.61% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| STEVEN S. RODRIGUES3 | 57 MEADOW LAKE DRIVE CRANSTON, RI 02921 | AFLAC | $736 | $0 | $736 | 5.00% |
| MJ INSURANCE3 Filed as: DEBRA DALY AND VARIOUS AGENTS | 338 READ SCHOOL HOUSE ROAD COVENTRY, RI 02816 | AFLAC | $304 | $0 | $304 | 2.07% |
| MARK S TAGLIAFERRI3 Filed as: MARK S. TAGLIAFERRI | 4 LEIGHAS LANE COVENTRY, RI 02816 | AFLAC | $207 | $0 | $207 | 1.41% |
| DAVID A. GAMACHE3 | 90 WATERWHEEL LANE NORTH KINGSTOWN, RI 02852 | AFLAC | $157 | $0 | $157 | 1.07% |
| KEVIN MCCARTHY3 Filed as: KEVIN T. MCCARTHY | 197 LANG DRIVE NORTH KINGSTOWN, RI 02852 | AFLAC | $121 | $0 | $121 | 0.82% |
| LYNNE F. KULISCH3 | 103 LAUREL HILL AVENUE, SUITE A PASCOAG, RI 02859 | AFLAC | $108 | $0 | $108 | 0.73% |
| STEVEN J. PHILLIPS3 | 10 RED COACH DRIVE COVENTRY, RI 02816 | AFLAC | $95 | $0 | $95 | 0.65% |
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 | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 251 | $1.7M |
| Vision | AFLAC | 16 | $15K |
| Life insurance(2 contracts, 2 carriers) | BOSTON MUTUAL LIFE INSURANCE COMPANY | 179 | $33K |
| Short-term disability | AFLAC | 16 | $15K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 251 | $1.7M |
| Other(2 contracts, 2 carriers) | BOSTON MUTUAL LIFE INSURANCE COMPANY | 179 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 251 | — |
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.