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Form 5500 · Employee benefit plan · PAWTUCKET, RI

YMCA OF PAWTUCKET, INC.

The filing calls this plan YMCA OF PAWTUCKET, INC. LIFE AND DISABILITY PLAN.

Public Form 5500 records show how YMCA OF PAWTUCKET, INC. of PAWTUCKET, RI, a health care and social assistance employer, structures its employee benefits. Its broker of record is DIGITAL INSURANCE INC.. Coverage is written through RELIANCE STANDARD LIFE INSURANCE COMPANY. The plan's most recent policy period ended in October.

Benefits broker of record
Policy year ends
Octoberas filed for plan year 2025

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 05-0259114 · plan 501 · plan year 2025, filed Mar 26, 2026

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How this plan is funded

Funding not settled by the filing

The filing does not report enough to settle how this plan pays for benefits.

All participants at the start of the year
125
Active at start of year
125
Active at end of year
136
Disclosed commissions
$3,431
Typical renewal
November 1

Benefits declared on this filing

Healthnot declared on this filing
Dentalnot declared on this filing
Visionnot declared on this filing
Lifeinsured — RELIANCE STANDARD LIFE INSURANCE COMPANY136 of 125 participants
Disabilityinsured — RELIANCE STANDARD LIFE INSURANCE COMPANY136 of 125 participants

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.

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 1 insured contract covering life and disability; the largest, with RELIANCE STANDARD LIFE INSURANCE COMPANY, covers 136 people.

Reported premium across the insured contracts is $27,203, with $3,431 in disclosed broker commissions — about 13% of premium.

The most recent policy period ended in October, and the plan year ends October 31. Group contracts typically renew on that annual cycle.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
RELIANCE STANDARD LIFE INSURANCE COMPANYLife, Disability136Nov 1, 2025$27,203$3,431

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
YMCA OF PAWTUCKET, INC.
EIN 05-0259114

The plan administrator is from line 3a of the main form. We publish company names only.

How this plan compares

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YMCA OF PAWTUCKET, INC. — benefits broker, carrier, renewal date · Form5500Lookup