| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $5K | $79K | $85K | 2.09% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | DELTA DENTAL OF RHODE ISLAND | $5K | — | $5K | 2.00% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $4K | $8K | 10.03% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.35% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $3K | $13K | 24.91% |
| FMLASOURCE INC5 | 455 N. CITYFRONT PLZ. DR., 13TH FL. CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $7K | $7K | 12.76% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 14.33% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | DELTA DENTAL OF RHODE ISLAND | $2K | — | $2K | 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 | 418 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 422 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 590 | $4.1M |
| Dental | DELTA DENTAL OF RHODE ISLAND | 724 | $238K |
| Vision | DELTA DENTAL OF RHODE ISLAND | 594 | $23K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 418 | $137K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 258 | $27K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 265 | $56K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 418 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 724 | — |
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.