| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 475 KILVERT STREET WARWICK, RI 02886 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $8K | $40K | $48K | 1.16% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $68K | $0 | $68K | 13.51% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $60 | $60 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 475 KILVERT STREET, SUITE 205 WARWICK, RI 02886 | DELTA DENTAL OF RHODE ISLAND | $6K | $0 | $6K | 1.76% |
| MERIDIEN BENEFIT GROUP3 | 10 DORRANCE STREET, SUITE 524 PROVIDENCE, RI 02903 | DELTA DENTAL OF RHODE ISLAND | $1K | $0 | $1K | 0.44% |
| USI INSURANCE SERVICES LLC3 | 475 KILVERT STREET, SUITE B-205 WARWICK, RI 02886 | VISION SERVICE PLAN | $2K | $0 | $2K | 7.00% |
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 | 300 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 308 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 556 | $4.1M |
| Dental | DELTA DENTAL OF RHODE ISLAND | 497 | $324K |
| Vision | VISION SERVICE PLAN | 180 | $29K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 300 | $503K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 300 | $503K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 300 | $503K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 556 | $4.1M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 300 | $503K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 556 | — |
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."
No prospect flags tripped on this filing.