| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY INC | P.O. BOX 549 PROVIDENCE, RI 02914 | BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND | $19K | — | $19K | 1.05% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY INC | 60 CATAMORE BOULEVARD EAST PROVIDENCE, RI 02914 | HARVARD PILGRAM HEALTH CARE | $8K | — | $8K | 2.99% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY INC | 60 CATAMORE BOULEVARD EAST PROVIDENCE, RI 02914 | DELTA DENTAL OF RHODE ISLAND | $5K | — | $5K | 2.81% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY INC | 60 CATAMORE BOULEVARD EAST PROVIDENCE, RI 02914 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 17.88% |
| ASSUREX3 | 175 SOUTH THIRD STREET SUITE 800 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $699 | — | $699 | 2.07% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY INC | 60 CATAMORE BOULEVARD EAST PROVIDENCE, RI 02914 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $246 | $3K | 9.28% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY INC | 60 CATAMORE BOULEVARD EAST PROVIDENCE, RI 02914 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $234 | $6K | 20.75% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY INC | 60 CATAMORE BOULEVARD EAST PROVIDENCE, RI 02914 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $227 | $5K | 15.75% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY INC | 60 CATAMORE BOULEVARD EAST PROVIDENCE, RI 02914 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $264 | $3K | 9.67% |
| FRED C. CHURCH INC.3 Filed as: FRED C CHURCH INC | 41 WELLMAN STREET LOWELL, MA 01851 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $969 | — | $969 | 4.39% |
| STARKWEATHER & SHEPLEY, INC.3 Filed as: STARKWEATHER & SHEPLEY INC | 60 CATAMORE BOULEVARD EAST PROVIDENCE, RI 02914 | HARVARD PILGRIM HEALTH CARE | $395 | — | $395 | 2.99% |
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 | 206 | 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) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND | 184 | $2.1M |
| Dental | DELTA DENTAL OF RHODE ISLAND | 325 | $173K |
| Vision | VISION SERVICE PLAN | 102 | $19K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 197 | $63K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 71 | $27K |
| Long-term disability(2 contracts) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 39 | $56K |
| Other(6 contracts, 3 carriers) | BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND | 197 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 325 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.