| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MONIZ BENEFITS GROUP, INC.3 Filed as: MONIZ BENEFITS GROUP INC | PO BOX 549 PROVIDENCE, RI 02901 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $68K | — | $68K | 3.47% |
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES MONIZ | 60 CATAMORE BOULEVARD EAST PROVIDENCE, RI 02914 | DELTA DENTAL OF RHODE ISLAND | $4K | — | $4K | 3.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: ARTHUR R WILLIS III | 18 HUNTINGTON DRIVE RUMFORD, RI 02916 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 7.17% |
| JOHN L MORRIS3 | 117 ALLISON STREET FORT MILL, SC 29715 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $89 | $2K | 3.92% |
| JAMES R SMITH INSURANCE LTD3 | 5835 POST ROAD SUITE 214 EAST GREENWICH, RI 02818 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $226 | $96 | $322 | 0.62% |
| DAVID L FLEURY3 | 545 SOUTH MAIN STREET PROVIDENCE, RI 02903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $184 | $53 | $237 | 0.46% |
| DONNA N DWYER3 | 1540 WESTBROOK PLAZA DRIVE WINSTON SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $116 | $107 | $223 | 0.43% |
| ELDER CARE INSURANCE SOLUTIONS3 Filed as: ELDER CARE INSURANCE SOLUTIONS INC | 44 HESPER DRIVE EAST GREENWICH, RI 02818 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $203 | — | $203 | 0.39% |
| PHIL COLEMAN | 18908 RIVERWIND LANE DAVIDSON, NC 28036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $116 | — | $116 | 0.22% |
| ROBERT S WHITEHEAD3 | 9050 HEARTHSTONE DRIVE ZIONSVILLE, IN 46077 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $48 | — | $48 | 0.09% |
| RICHARD HASKINS3 | 22 WEST STREET MILLBURY, MA 01527 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $319 | $4K | 15.07% |
| STARKWEATHER & SHEPLEY, INC.3 | PO BOX 549 PROVIDENCE, RI 02901 | VISION SERVICE PLAN | $944 | — | $944 | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 13.48% |
| HADSELL BENJAMIN JENNESS JR3 Filed as: HADSELL BENJEMIN JENNESS JR | 34 BRIDGHAM FARM ROAD RUMFORD, RI 02916 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $589 | — | $589 | 5.39% |
| ST JEAN RICHARD A JR.3 Filed as: ST JEAN RICHARD A JR | 101 FEDERAL STREET SUITE 800 BOSTON, MA 02110 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $267 | $79 | $346 | 3.17% |
| ANDERSON GREGG A3 | 101 FEDERAL STREET SUITE 800 BOSTON, MA 02110 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $113 | — | $113 | 1.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 6330 SOUTH 3000 EAST SUITE 670 SALT LAKE CITY, UT 84121 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $101 | $1 | $102 | 0.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | PO BOX 9146 NORWELL, MA 02061 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $95 | — | $95 | 0.87% |
| TUDOR RISK SERVICES, INC3 | 2 PIERCE PLACE FLOOR 14 ITASCA, IL 60143 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $51 | — | $51 | 0.47% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES, INC | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $826 | — | $826 | 20.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR JA GALLAGHER | 300 TRADE CENTER WOBURN, ME 01801 | FEDERAL INSURANCE COMPANY | $620 | — | $620 | 15.01% |
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 | 192 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 343 | $1.9M |
| Dental | DELTA DENTAL OF RHODE ISLAND | 348 | $135K |
| Vision | VISION SERVICE PLAN | 92 | $19K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 191 | $27K |
| Long-term disability(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 132 | $29K |
| Other(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 191 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 348 | — |
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.