| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSURED SKCG INC | 123 MAIN STREET 14TH FLOOR WHITE PLAINS, NY 10601 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | — | $117K | $117K | 4.78% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NORTHEAST | 123 MAIN STREET, 14TH FLOOR WHITE PLAINS, NY 10601 | DELTA DENTAL OF RHODE ISLAND | $7K | — | $7K | 2.12% |
| ASSUREDPARTNERS3 Filed as: ASSURED SKCG, INC. | 123 MAIN STREET FL 14 WHITE PLAINS, NY 10601 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $13K | — | $13K | 10.73% |
| ASSUREDPARTNERS3 Filed as: ASSURED SKCG INC | 123 MAIN ST 14TH FLOOR WHITE PLAINS, NY 10601 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 3.36% |
| ASSUREDPARTNERS3 Filed as: ASSURED SKCG INC | 123 MAIN ST 14TH FLOOR WHITE PLAINS, NY 10601 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 5.44% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NORTHEAST LLC | 123 MAIN ST FL 14 WHITE PLAINS, NY 10601 | VISION SERVICE PLAN | $2K | — | $2K | 2.95% |
| TOMMY TAM3 | 418 EAST 74TH STREET NEW YORK, NY 10021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $329 | $23 | $352 | 11.67% |
| ASSUREDPARTNERS3 Filed as: ASSURED SKCG INC | 123 MAIN ST FL 14 WHITE PLAINS, NY 10601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | — | $71 | 2.35% |
| KATHLEEN ENGELMAN GULLA3 | 118 OAKWOODS DRIVE WAKEFIELD, RI 02879 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | $12 | $67 | 2.22% |
| USI INSURANCE SERVICES LLC3 | 12 GILL STREET STE 5500 WOBURN, MA 01801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | — | $49 | 1.62% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NORTHEAST LLC | 123 MAIN ST FL 14 WHITE PLAINS, NY 10601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | — | $36 | 1.19% |
| KRISTY COLGATE3 | 43 MAGILL DR. GRAFTON, MA 01519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 1.09% |
| ENROLLMENT SOLUTIONS LTD3 | 65 BURBANK RD SUTTON, MA 01590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.80% |
| RICHARD WILLIAM HARRINGTON3 | 3 POISSON STREET CUMBERLAND, RI 02864 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.50% |
| ADAM MAGGIO3 | 1450 GARDEN STREET HOBOKEN, NJ 07030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $6 | $14 | 0.46% |
| THOMAS E KIENZLER3 Filed as: THOMAS KIENZLER | 359 WASHINGTON RD ENFIELD, CT 06082 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.43% |
| DAVID L FLEURY3 | 162 INDIAN POINT RD TIVERTON, RI 02878 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.23% |
| J KING INSURANCE INC3 | 5835 POST ROAD EAST GREENWICH, RI 02818 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $3 | $7 | 0.23% |
| JAMES R SMITH INSURANCE LTD3 | 5835 POST ROAD STE 214 EAST GREENWICH, RI 02818 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $2 | $6 | 0.20% |
| BRIAN SUMMERS3 | 2474 GREEN POINT LN DENVER, NC 28037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| SAMUEL DAVID BREIER3 | 34 GRAMERCY PARK EAST NEW YORK, NY 10003 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INTERFLEX PAYMENTS, LLC EIN 27-2256926 FSA/COBRA ADMIN | Contract Administrator Service code 13 | — | $20K |
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 | 173 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 173 | $2.6M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF RHODE ISLAND | 173 | $471K |
| Vision | VISION SERVICE PLAN | 170 | $61K |
| Life insurance(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 167 | $201K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 167 | $67K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 173 | $2.4M |
| Other(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 167 | $204K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.