| 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 | $2K | $36K | $38K | 2.08% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | — | $3K | $3K | 3.72% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE 240 CRANSTON, RI 02920 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $514 | $9K | 20.24% |
| LAURIE SEUBERT3 Filed as: LAURIE SEUBERT-LEMIRE | 50 MAIN ST., STE. 200 EAST GREENWICH, RI 02818 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $283 | $1K | 2.99% |
| J KING INSURANCE INC3 Filed as: J KING INSURANCE INC. | 50 MAIN ST., STE. 200 EAST GREENWICH, RI 02818 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $252 | $215 | $467 | 1.01% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $5K | 17.10% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 14.98% |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 208 | $1.8M |
| Dental | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 199 | $85K |
| Vision | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 208 | $1.8M |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 117 | $72K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 30 | $46K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $27K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 117 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 208 | — |
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.