| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 12 GILL STREET WOBURN, MA 01801 | BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND | $85K | — | $85K | 3.20% |
| OCEANPOINT INSURANCE AGENCY3 | 272 VALLEY ROAD MIDDLETOWN, RI 02842 | DELTA DENTAL OF RHODE ISLAND | $5K | — | $5K | 2.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 12 GILL STREET, SUITE 5500 WOBURN, MA 01801 | SYMETRA LIFE INSURANCE COMPANY | $20K | $3K | $22K | 16.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 775 YARD STREET, SUITE 200 COLUMBUS, OH 43212 | FEDERAL INSURANCE COMPANY | $5K | — | $5K | 15.06% |
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 | 253 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND | 485 | $2.7M |
| Dental | DELTA DENTAL OF RHODE ISLAND | 508 | $182K |
| Vision | VISION SERVICE PLAN | 146 | $32K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 253 | $132K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 253 | $132K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND | 485 | $2.7M |
| Other(4 contracts, 4 carriers) | SYMETRA LIFE INSURANCE COMPANY | 280 | $176K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 508 | — |
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.