| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WI, INC | PO BOX 1650 MILWAUKEE, WI 532011650 | RELIASTAR LIFE INSURANCE COMPANY | $34K | — | $34K | 4.07% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS INC. | PO BOX 28 DUBUQUE, IA 520040028 | RELIASTAR LIFE INSURANCE COMPANY | $21K | — | $21K | 2.50% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN, INC. | 101 S GARLAND AVE STE 203 ORLANDO, FL 328013277 | RELIASTAR LIFE INSURANCE COMPANY | — | $8K | $8K | 1.00% |
| COTTINGHAM & BUTLER3 | 800 MAIN STREET DUBUQUE, IA 52001 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | $30K | — | $30K | 7.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93033 NETWORK PLACE CHICAGO, IL 606731930 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | $3K | — | $3K | 0.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 93033 NETWORK PLACE CHICAGO, IL 606731930 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 1.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.09% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS INC | 800 MAIN STREET DUBUQUE, IA 52002 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 0.87% |
| TYLER LANGE3 | COTTINGHAM AND BUTLER 2323 CROSSROADS DR STE 220 DUBUQUE, IA 520010000 | DELTA DENTAL OF WISCONSIN | $487 | — | $487 | 0.40% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | C/O JP MORGAN CHASE 93033 NETWORK PLACE CHICAGO, IL 60673 | METLIFE LEGAL PLANS | $4K | $899 | $4K | 6.41% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS INC | 800 MAIN STREET PO BOX 28 DUBUQUE, IA 52004 | METLIFE LEGAL PLANS | $3K | $114 | $4K | 5.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | 93033 NETWORK PLACE CHICAGO, IL 60673 | METLIFE LEGAL PLANS | — | $31 | $31 | 0.04% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS INC | 800 MAIN STREET DUBUQUE, IA 52002 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $548 | — | $548 | 5.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 93033 NETWORK PLACE CHICAGO, IL 606731930 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $547 | — | $547 | 5.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $45 | $45 | 0.45% |
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 | 2,310 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 42 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,352 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 272 | $121K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | 1,752 | $408K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 3,676 | $845K |
| Short-term disability | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 130 | $10K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,501 | $279K |
| Other | METLIFE LEGAL PLANS | 340 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,676 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.