| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 50 BRAINTREE HILL OFFICE PARK SUITE 310 BRAINTREE, MA 02184 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $30K | — | $30K | 1.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | DELTA DENTAL OF RHODE ISLAND | $4K | — | $4K | 3.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE, 10TH FLOOR BOSTON, MA 02116 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 10.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $345 | $345 | 1.37% |
| CORNERSTONE FINANCIAL LLP3 Filed as: CORNERSTONE FINANCIAL GROUP, INC. | 931 JEFFERSON BOULEVARD, SUITE 3001 WARWICK, RI 02886 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $164 | $9 | $173 | 0.68% |
| CORNERSTONE FINANCIAL LLP3 Filed as: CORNERSTONE FINANCIAL GROUP, INC. | 931 JEFFERSON BOULEVARD, SUITE 3001 WARWICK, RI 02886 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $180 | — | $180 | 1.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | EYEMED VISION CARE | $315 | — | $315 | 8.85% |
| CORNERSTONE FINANCIAL LLP3 Filed as: CORNERSTONE FINANCIAL GROUP | 931 JEFFERSON BOULEVARD, SUITE 3001 WARWICK, RI 02886 | EYEMED VISION CARE | $34 | — | $34 | 0.96% |
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 | 167 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 343 | $1.6M |
| Dental | DELTA DENTAL OF RHODE ISLAND | 321 | $122K |
| Vision | EYEMED VISION CARE | 32 | $4K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 248 | $25K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 248 | $25K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 343 | $1.6M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 248 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 343 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.