| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 555 PLEASANTVILLE ROAD BRIARCLIFF MANOR, NY 10510 | HARVARD PILGRIM HEALTH CARE | $37K | — | $37K | 1.66% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 12 GILL STREET, SUITE 5500 WOBURN, MA 01801 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $104 | $2K | 5.24% |
| KRISTY COLGATE3 | 43 MAGILL DRIVE GRAFTON, MA 01519 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $238 | $2K | 3.45% |
| ENROLLMENT SOLUTIONS LTD3 | 14 WUNSCHEL DRIVE SUTTON, MA 01590 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $247 | $1K | 2.89% |
| MARY-JOYCE LICATA3 | 583 HATCHERY ROAD NORTH KINGSTOWN, RI 02852 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $486 | $166 | $652 | 1.41% |
| DAVID L FLEURY3 Filed as: DAVID L. FLEURY | 545 SOUTH MAIN STREET PROVIDENCE, RI 02903 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $267 | $75 | $342 | 0.74% |
| INNOVATIVE PARTNERS LLC3 Filed as: INNOVATIVE PARTNERS, LLC | UNKNOWN MIDDLETOWN, CT 06457 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $103 | $5 | $108 | 0.23% |
| RICHARD WILLIAM HARRINGTON3 | 3 POISSON STREET CUMBERLAND, RI 02864 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $106 | — | $106 | 0.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 12 GILL STREET, SUITE 5500 WOBURN, MA 01801 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 10.59% |
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 | 244 | 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) | 244 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 425 | $2.2M |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 244 | $88K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 244 | $42K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE | 425 | $2.2M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 244 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 425 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.