Form 5500 · Employee benefit plan · NORTH KINGSTOWN, RI
DOMINION DIAGNOSTICS, LLC
The filing calls this plan DOMINION DIAGNOSTICS, LLC CONSOLIDATED WELFARE BENEFITS PLAN.
DOMINION DIAGNOSTICS, LLC of NORTH KINGSTOWN, RI files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is USI INSURANCE SERVICES LLC. Coverage is written through BLUE CROSS BLUE SHIELD OF RHODE ISLAND and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 54-1882269 · plan 501 · plan year 2024, filed Jun 25, 2025
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170 other employer plans in Rhode Island have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
2 contracts on this filing do not say which benefits they cover, so a line above may be insured by one of them.
Also declared: death benefits, other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 7 insured contracts covering health, vision, life and disability; the largest, with BLUE CROSS BLUE SHIELD OF RHODE ISLAND, covers 422 people.
The filing declares health, vision, life, disability and dental. Dental appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on one of the 2 contracts here that do not say what they cover.
Reported premium across the insured contracts is $3,388,514, with $29,082 in disclosed broker commissions — about 0.9% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
USI INSURANCE SERVICES LLC is the broker of record on 5 of the 7 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Life, Disability | — | Jan 1, 2025 | $142,157 | $11,642 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | 363 | Jan 1, 2025 | $39,429 | $5,968 |
| BLUE CROSS BLUE SHIELD OF RHODE ISLAND | Health | 422 | Jan 1, 2025 | $3,145,622 | $5,954 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | Disability | 9 | Jan 1, 2025 | $20,728 | $4,146 |
| VISION SERVICE PLAN | Vision | 199 | Jan 1, 2025 | $28,995 | $1,372 |
| COASTLINE EAP | — | 355 | Jan 1, 2025 | $7,455 | $0 |
| BLUE CROSS BLUE SHIELD OF RHODE ISLAND | Health | 2 | Jan 1, 2025 | $4,128 | $0 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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Renewal calendar
170 other employer plans in Rhode Island are January 1 renewals (policy year ends December).
Their policy years end in December, like this plan’s, so most renew January 1. The calendar lists every insured group by renewal date and state, with broker of record, carrier and disclosed commission. You can preview the five largest in each month for free.
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