| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R & R INSURANCE SERVICES INC3 Filed as: R & R INSURANCE SERVICES, INC | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | ANTHEM LIFE INSURANCE COMPANY (G1400) | — | — | $0 | 0.00% |
| R&R INSURANCE3 | SERVICES INC. N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | ANTHEM LIFE INSURANCE COMPANY (G1400) | — | — | $0 | 0.00% |
| R & R INSURANCE SERVICES INC3 Filed as: R & R INSURANCE SERVICES | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | $2K | — | $2K | 10.00% |
| HAUSMANN-JOHNSON INSURANCE INC3 | PO BOX 259408 MADISON, WI 53725 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | $0 | $0 | $0 | 0.00% |
| R&R INS SER INC3 | N14 W23900 STONE RIDGE DR WAUKESHAR, WI 531881135 | HUMANADENTAL INSURANCE COMPANY | — | — | $0 | 0.00% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES, INC | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | — | $1K | $61 | $1K | 15.76% |
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 | 201 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 201 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 402 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY (G1400) | 201 | $113K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 125 | $21K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY (G1400) | 201 | $104K |
| Long-term disability | 30 | $8K | |
| Stop-loss / reinsurancereinsurance | ANTHEM LIFE INSURANCE COMPANY (G1400) | 201 | $104K |
| Other | ANTHEM LIFE INSURANCE COMPANY (G1400) | 201 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 201 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.