| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF NEW ENGLAND, LLC | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $2K | $52K | $54K | 1.96% |
| RICHARD RACINE3 | 52 PHILLIP STREET MEDFIELD, MA 02052 | DELTA DENTAL OF RHODE ISLAND | $2K | — | $2K | 2.72% |
| RICHARD RACINE3 | 52 PHILLIP STREET MEDFIELD, MA 02052 | DELTA DENTAL OF RHODE ISLAND | $2K | — | $2K | 2.72% |
| RICHARD RACINE3 Filed as: RICHARD R RACINE | 52 PHILLIP STREET MEDFIELD, MA 02052 | BROOKWOOD COMPANIES INCORPORATED | $5K | — | $5K | 10.00% |
| COMBINED SERVICES LLC3 | 2 DELTA DRIVE, STE. 301 CONCORD, NH 03301 | BROOKWOOD COMPANIES INCORPORATED | $2K | — | $2K | 5.00% |
| RICHARD RACINE3 | 52 PHILLIP STREET MEDFIELD, MA 02052 | DELTA DENTAL OF RHODE ISLAND | $690 | — | $690 | 2.71% |
| RICHARD RACINE3 Filed as: RICHARD R RACINE | 52 PHILLIP STREET MEDFIELD, MA 02052 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 12.98% |
| COMBINED SERVICES LLC3 | 2 DELTA DRIVE, STE. 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| RICHARD RACINE3 Filed as: RICHARD R RACINE | 52 PHILLIP STREET MEDFIELD, MA 02052 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 24.00% |
| COMBINED SERVICES LLC3 | 2 DELTA DRIVE, STE. 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| RICHARD RACINE3 Filed as: RICHARD R RACINE | 52 PHILLIP STREET MEDFIELD, MA 02052 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 30.00% |
| RICHARD RACINE3 Filed as: RICHARD RANCINE | 52 PHILLIP STREET MEDFIELD, MA 02052 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 11.00% |
| COMBINED SERVICES LLC3 | 2 DELTA DRIVE, STE. 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $599 | — | $599 | 5.00% |
| RICHARD RACINE3 Filed as: RICHARD ROBERT RACINE | 52 PHILIP STREET MEDFIELD, MA 02052 | COMPANION LIFE INSURANCE COMPANY | $455 | — | $455 | 10.00% |
| RICHARD RACINE3 | 52 PHILIP ST. MEDFIELD, MA 02052 | MUTUAL OF OMAHA INSURANCE COMPANY | $442 | — | $442 | 15.00% |
| RICHARD RACINE3 Filed as: RICHARD R. RACINE | 52 PHILIP ST. MEDFIELD, MA 02052 | MUTUAL OF OMAHA INSURANCE COMPANY | $238 | — | $238 | 10.01% |
| RICHARD RACINE3 Filed as: RICHARD R RACINE | 52 PHILLIP STREET MEDFIELD, MA 02052 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $273 | — | $273 | 15.02% |
| COMBINED SERVICES LLC3 | 2 DELTA DRIVE, STE. 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $91 | — | $91 | 5.01% |
| RICHARD RACINE3 | 52 PHILIP STREET MEDFIELD, MA 02052 | MUTUAL OF OMAHA INSURANCE COMPANY | $36 | — | $36 | 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 | 350 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 351 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 451 | $2.8M |
| Dental(3 contracts) | DELTA DENTAL OF RHODE ISLAND | 129 | $155K |
| Life insurance(4 contracts, 4 carriers) | BROOKWOOD COMPANIES INCORPORATED | 354 | $75K |
| Short-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 62 | $14K |
| Long-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 107 | $28K |
| Other(5 contracts, 3 carriers) | BROOKWOOD COMPANIES INCORPORATED | 354 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 451 | — |
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.