| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND LLC | 931 JEFFERSON BLVD., STE. 3001 WARWICK, RI 02886 | BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND | $5K | $52K | $56K | 2.24% |
| RICHARD RACINE3 | 185 CHARLES RIVER ST. NEEDHAM, MA 02492 | DELTA DENTAL OF RHODE ISLAND | $2K | — | $2K | 2.71% |
| RICHARD RACINE3 | 185 CHARLES RIVER ST. NEEDHAM, MA 02492 | DELTA DENTAL OF RHODE ISLAND | $2K | — | $2K | 2.71% |
| RICHARD RACINE3 Filed as: RICHARD ROBERT RACINE | 52 PHILIP STREET MEDFIELD, MA 02052 | COMPANION LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| RICHARD RACINE3 | 185 CHARLES RIVER ST. NEEDHAM, MA 02492 | DELTA DENTAL OF RHODE ISLAND | $906 | — | $906 | 2.71% |
| RICHARD RACINE3 | 52 PHILIP ST MEDFIELD, MA 02052 | MUTUAL OF OMAHA INSURANCE COMPANY | $3K | — | $3K | 12.49% |
| RICHARD RACINE3 Filed as: RICHARD R. RACINE | 52 PHILIP ST. MEDFIELD, MA 02052 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| RICHARD RACINE3 | 185 CHARLES RIVER ST. NEEDHAM, MA 02492 | DELTA DENTAL OF RHODE ISLAND | $618 | — | $618 | 2.71% |
| RICHARD RACINE3 | 52 PHILIP STREET MEDFIELD, MA 02052 | MUTUAL OF OMAHA INSURANCE COMPANY | $407 | — | $407 | 10.01% |
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 | 364 | 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) | 368 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND | 446 | $2.5M |
| Dental(4 contracts) | DELTA DENTAL OF RHODE ISLAND | 150 | $196K |
| Life insurance(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 364 | $55K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 58 | $24K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 99 | $27K |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 364 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 446 | — |
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.