| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $602 | $3K | 19.44% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $793 | $355 | $1K | 14.47% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $719 | $319 | $1K | 14.43% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 22.83% |
| R FINE & R FINE INS LLC3 Filed as: R FINE & R FINE INS. LLC | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13 | — | $13 | 0.23% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | EYEMED VISION CENTER CARE OBO FIDELITY SECURITY LIFE INSURANCE COMPANY | $86 | — | $86 | 8.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH PLANS, INC. EIN 04-2734278 THIRD PARTY ADMINISTRATO | Other services; Claims processing Service code 12 | — | $37K |
| HILB GROUP OF NEW ENGLAND BROKER | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | 2000 CHAPEL VIEW BLVD. STE.240 CRANSTON, RI 02920 | $30K |
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 |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 68 | $6K |
| Vision | EYEMED VISION CENTER CARE OBO FIDELITY SECURITY LIFE INSURANCE COMPANY | 14 | $1K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $8K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $14K |
| Stop-loss / reinsurancereinsurance | PROSELECT INSURANCE COMPANY DBA COVERYS | 54 | $153K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.