| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROSS INSURANCE3 Filed as: CROSS INSURANCE INC RHODE ISLAND | 376 NEWPORT AVENUE EAST PROVIDENCE, RI 02916 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $3K | $19K | $22K | 3.14% |
| PGIA, INC DBA PROVIDER INSURANCE3 Filed as: PGIA, INC. DBA PROVIDER INSURANCE | P.O. BOX 1388 BANGOR, ME 04402 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | — | $4K | $4K | 0.51% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE INC RHODE ISLAND | 376 NEWPORT AVENUE EAST PROVIDENCE, RI 02916 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | — | $2K | $2K | 3.45% |
| PGIA, INC DBA PROVIDER INSURANCE3 Filed as: PGIA, INC. DBA PROVIDER INSURANCE | P.O. BOX 1388 BANGOR, ME 04402 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | — | $376 | $376 | 0.76% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE INC RHODE ISLAND | 376 NEWPORT AVENUE RUMFORD, RI 02916 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 11.05% |
| PGIA, INC.3 Filed as: PGIA INC | 275 PROMENADE STREET SUITE 135 PROVIDENCE, RI 02908 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $532 | — | $532 | 3.95% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE INC RHODE ISLAND | 376 NEWPORT AVENUE RUMFORD, RI 02916 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 11.16% |
| PGIA, INC.3 Filed as: PGIA INC | 275 PROMENADE STREET SUITE 135 PROVIDENCE, RI 02908 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $414 | — | $414 | 3.85% |
| CROSS BENEFIT SOLUTIONS3 Filed as: CROSS FINANCIAL CORP | 491 MAIN STREET BANGOR, ME 04401 | VISION SERVICE PLAN | $578 | — | $578 | 7.39% |
| PGIA, INC DBA PROVIDER INSURANCE3 | 275 PROMENADE STREET SUITE 135 PROVIDENCE, RI 02908 | VISION SERVICE PLAN | $34 | — | $34 | 0.43% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE INC RHODE ISLAND | 376 NEWPORT AVENUE RUMFORD, RI 02916 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $484 | — | $484 | 7.34% |
| PGIA, INC.3 Filed as: PGIA INC | 275 PROMENADE STREET SUITE 135 PROVIDENCE, RI 02908 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $176 | — | $176 | 2.67% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE INC RHODE ISLAND | 376 NEWPORT AVENUE RUMFORD, RI 02916 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $455 | — | $455 | 7.58% |
| PGIA, INC.3 Filed as: PGIA INC | 275 PROMENADE STREET SUITE 135 PROVIDENCE, RI 02908 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $145 | — | $145 | 2.41% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 85 | $694K |
| Dental | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 90 | $49K |
| Vision | VISION SERVICE PLAN | 69 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $17K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 22 | $6K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 35 | $13K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 128 | — |
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.