| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS | PO BOX 632886 CINCINNATI, OH 45263 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | — | $41K | $41K | 1.83% |
| JAMIE MORAN3 | 275 PROMENADE STREET PROVIDENCE, RI 02908 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | — | $31K | $31K | 1.38% |
| PROVIDER INSURANCE GROUP, LLC3 Filed as: PROVIDER INSURANCE GROUP, INC. | 275 PROMENADE STREET PROVIDENCE, RI 02908 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $3K | — | $3K | 0.14% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS | PO BOX 632886 CINCINNATI, OH 45263 | DELTA DENTAL OF RHODE ISLAND | $1K | — | $1K | 1.21% |
| PROVIDER INSURANCE3 | 160 GOULD STREET SUITE 130 NEEDHAM, MA 02494 | DELTA DENTAL OF RHODE ISLAND | $1K | — | $1K | 1.18% |
| CROSS INSURANCE3 Filed as: CROSS INS. DBA PROVIDER | PO BOX 1388 BANGOR, ME 04402 | DELTA DENTAL OF RHODE ISLAND | $268 | — | $268 | 0.24% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS | PO BOX 632886 CINCINNATI, OH 45263 | DELTA DENTAL OF RHODE ISLAND | $1K | — | $1K | 1.21% |
| PROVIDER INSURANCE3 | 160 GOULD STREET SUITE 130 NEEDHAM, MA 02494 | DELTA DENTAL OF RHODE ISLAND | $1K | — | $1K | 1.18% |
| CROSS INSURANCE3 Filed as: CROSS INS. DBA PROVIDER | PO BOX 1388 BANGOR, ME 04402 | DELTA DENTAL OF RHODE ISLAND | $258 | — | $258 | 0.24% |
| PROVIDER INSURANCE GROUP, LLC3 Filed as: PROVIDER INSURANCE GROUP | 160 GOULD STREET SUITE 122 NEEDHAM, MA 02494 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 12.16% |
| PROVIDER INSURANCE GROUP, LLC3 | 275 PROMENADE STREET SUITE 135 PROVIDENCE, RI 02908 | VISION SERVICE PLAN | $1K | — | $1K | 4.98% |
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 | 305 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 305 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 555 | $2.2M |
| Dental(2 contracts) | DELTA DENTAL OF RHODE ISLAND | 307 | $223K |
| Vision | VISION SERVICE PLAN | 217 | $23K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 387 | $104K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 387 | $104K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 387 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 555 | — |
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.