# CLEMENTS MARKETPLACE, INC. EMPLOYEE BENEFITS PLAN

Health and welfare plan sponsored by **CLEMENTS MARKETPLACE, INC.**. Form 5500 filing for plan year 2026.

| Field | Value |
|---|---|
| Sponsor | CLEMENTS MARKETPLACE, INC. |
| EIN | 050389042 |
| Plan number | 501 |
| Plan year | 2026 |
| Location | PORTSMOUTH, RI |
| Industry | Retail Trade |
| Funding | fully insured |
| Total premiums | $1.2M |
| Participants | 119 |
| Persons covered | 142 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| BLUE CROSS BLUE SHIELD OF RHODE ISLAND | Health |
| DELTA DENTAL OF RHODE ISLAND | Dental, Vision |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Other |
| MUTUAL OF OMAHA INSURANCE COMPANY | Life, Other |

## Brokers

| Broker | Placed with |
|---|---|
| HILB GROUP OF NEW ENGLAND | BLUE CROSS BLUE SHIELD OF RHODE ISLAND |
| HILB GROUP OF NEW ENGLAND | DELTA DENTAL OF RHODE ISLAND |
| MARYSE HATHAWAY | UNUM LIFE INSURANCE COMPANY OF AMERICA |
| HILB GROUP OF NEW ENGLAND | UNITED OF OMAHA LIFE INSURANCE COMPANY |
| NATIONAL ENROLLMENT PARTNERS LLC | UNITED OF OMAHA LIFE INSURANCE COMPANY |

## About this data

- Source: public Form 5500 filings from the U.S. Department of Labor (EBSA), rebuilt on each DOL release.
- Full page (charts, history, peer benchmarks, fees, contacts): https://planoptica.com/welfare/050389042-501
- Cite as: PlanOptica, https://planoptica.com/welfare/050389042-501
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