| 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 | $0 | $46K | $46K | 2.38% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $20K | $0 | $20K | 10.69% |
| USI INSURANCE SERVICES LLC3 | 555 PLEASANTVILLE ROAD BRIARCLIFF MANOR, NY 10510 | STANDARD INSURANCE COMPANY | $0 | $4K | $4K | 2.38% |
| USI INSURANCE SERVICES LLC3 | 475 KILVERT STREET BUILDING B, SUITE 205 WARWICK, RI 05403 | VISON SERVICE PLAN | $1K | $0 | $1K | 4.59% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $877 | $0 | $877 | 10.58% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES OF RI | 5700 POST ROAD PO BOX 1158 EAST GREENWICH, RI 02818 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $487 | $0 | $487 | 5.88% |
| WEB TPA3 | 8500 FREEPORT PARKWAY SOUTH IRVING, TX 75063 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $246 | $0 | $246 | 2.97% |
| BROKERNET INC3 Filed as: BROKERNET | 100 METRO CENTER BOULEVARD WARWICK, RI 02886 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $97 | $0 | $97 | 1.17% |
| EASTERN INSURANCE GROUP LLC3 Filed as: EASTERN INSURANCE GROUP, LLC | 233 WEST CENTRAL STREET NATICK, MA 01760 | FEDERAL INSURANCE COMPANY | $540 | $0 | $540 | 20.00% |
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 | 216 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 327 | $2.0M |
| Vision | VISON SERVICE PLAN | 157 | $31K |
| Life insurance | STANDARD INSURANCE COMPANY | 216 | $186K |
| Long-term disability | STANDARD INSURANCE COMPANY | 216 | $186K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 327 | $2.0M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 216 | $188K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 327 | — |
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.