| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES OF RI INC | 475 KILVERT STREET WARWICK, RI 02886 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $9K | $95K | $104K | 1.90% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | DELTA DENTAL OF RHODE ISLAND | $8K | $0 | $8K | 2.00% |
| THOMAS SOWINSKI3 Filed as: THOMAS SOWINSKI SR | 370 PORTSMOUTH AVENUE GREENLAND, NH 03840 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 6.65% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $125 | $125 | 0.08% |
| WD & ASSOC. A DIV. OF PGIS LLC3 | 34 HEMINGWAY DR RIVERSIDE, RI 02915 | UNITED HEALTH INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
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 | 940 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 940 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 830 | $5.5M |
| Dental | DELTA DENTAL OF RHODE ISLAND | 822 | $395K |
| Vision | UNITED HEALTH INSURANCE COMPANY | 940 | $43K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 675 | $164K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 675 | $164K |
| Other | UNITED BEHAVIORAL HEALTH DBA OPTUM | 615 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 940 | — |
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.