| 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 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $559 | $5K | 5.76% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES, INC | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $142 | $3K | 6.38% |
| 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. | $3K | — | $3K | 9.96% |
| R&R INS SER INC3 | N14 W23900 STONE RIDGE DR WAUKESHA, WI 531881135 | HUMANADENTAL INSURANCE COMPANY | $477 | — | $477 | 5.82% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES, INC | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $982 | — | $982 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $68K |
| R&R INSURANCE SERVICES INC. EIN 39-1230987 BROKER | Other commissions Service code 55 | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | $41K |
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 | 302 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 302 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANADENTAL INSURANCE COMPANY | 191 | $8K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 302 | $31K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 243 | $50K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 39 | $7K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 181 | $748K |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 243 | $149K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 302 | — |
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.