| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROVIDER INSURANCE GROUP, LLC3 Filed as: PROVIDER INSURANCE GROUP LLC | 160 GOULD ST STE 130 NEEDHAM HGTS, MA 02494 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 0.92% |
| PGIA, INC.3 | 160 GOULD ST., STE 122 NEEDHAM, MA 02494 | DELTA DENTAL OF RHODE ISLAND | $4K | — | $4K | 2.00% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE, INC | PO BOX 1388 BANGOR, ME 04402 | DELTA DENTAL OF RHODE ISLAND | $141 | — | $141 | 0.07% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE, INC | 275 PROMENADE STREET SUITE 135 PROVIDENCE, RI 02908 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 9.24% |
| PROVIDER INSURANCE GROUP, LLC3 Filed as: PROVIDER INSURANCE GROUP LLC | 160 GOULD ST STE 130 NEEDHAM HGTS, MA 02494 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 2.34% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE, INC | 275 PROMENADE STREET SUITE 135 PROVIDENCE, RI 02908 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 13.59% |
| PGIA, INC.3 | 160 GOULD ST., STE 122 NEEDHAM, MA 02494 | DELTA DENTAL OF RHODE ISLAND | $11 | — | $11 | 1.94% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE, INC | PO BOX 1388 BANGOR, ME 04402 | DELTA DENTAL OF RHODE ISLAND | $4 | — | $4 | 0.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 9900 BREN ROAD EAST MINNETONKA, MN 55343 | $22K |
| PROVIDER INSURANCE GROUP LLC EIN 27-2005964 BROKER | Other commissions Service code 55 | 160 GOULD ST STE 130 NEEDHAM HGTS, MA 02494 | $0 |
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 | 567 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 567 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 539 | $495K |
| Dental(2 contracts) | DELTA DENTAL OF RHODE ISLAND | 567 | $211K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 539 | $62K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 377 | $68K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 377 | $68K |
| Stop-loss / reinsurancereinsurance(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 539 | $495K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 377 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 567 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.