Form 5500 · Employee benefit plan · WARWICK, RI
WEST BAY RESIDENTIAL SERVICES, INC.
The filing calls this plan WEST BAY RESIDENTIAL SERVICES, INC. WELFARE WRAP PLAN.
WEST BAY RESIDENTIAL SERVICES, INC. of WARWICK, RI spreads its employee benefits across 4 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is JAMES F CARROLL. Coverage is written through BLUE CROSS BLUE SHIELD OF RHODE ISLAND and 3 other carriers. The plan's most recent policy period ended in February.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 05-0395035 · plan 510 · plan year 2026, filed Jun 1, 2026
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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
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 6 insured contracts covering health, dental, vision and life; the largest, with BLUE CROSS BLUE SHIELD OF RHODE ISLAND, covers 442 people.
Reported premium across the insured contracts is $3,473,345, with $9,788 in disclosed broker commissions — about 0.3% of premium.
The health contract's policy period ended in February, while at least one ancillary line's policy period ended in October. The plan is on a split renewal cycle.
JAMES F CARROLL is the broker of record on 1 of the 6 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including BLUE CROSS BLUE SHIELD OF RHODE ISLAND, RELIANCE STANDARD LIFE INSURANCE COMPANY, EYEMED VISION CARE and DELTA DENTAL OF RHODE ISLAND. BLUE CROSS BLUE SHIELD OF RHODE ISLAND writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Life | 345 | Nov 1, 2025 | $25,908 | $3,459 |
| DELTA DENTAL OF RHODE ISLAND | Dental | 440 | Mar 1, 2026 | — | $2,389 |
| BLUE CROSS BLUE SHIELD OF RHODE ISLAND | Health | 442 | Mar 1, 2026 | $3,430,366 | $2,170 |
| EYEMED VISION CARE | Vision | 132 | Mar 1, 2026 | $17,071 | $1,749 |
| DELTA DENTAL OF RHODE ISLAND | Dental | 4 | Mar 1, 2026 | — | $15 |
| DELTA DENTAL OF RHODE ISLAND | Dental | 3 | Mar 1, 2026 | — | $6 |
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.
Reported to OSHA
Reported to OSHA for 2025: 184 employees, 18 recordable cases, 73 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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