| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R&R INS SER INC3 | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORAT | $31K | $1K | $32K | 3.29% |
| R&R INS SER INC3 | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | HUMANA INSURANCE COMPANY | $5K | $1K | $6K | 6.27% |
| R & R INSURANCE SERVICES INC3 | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $662 | $5K | 14.77% |
| CARUTH, JENNON, M3 | 7825 WASHINGTON AVENUE SOUTH SUITE 710 BLOOMINGTON, MN 55439 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $107 | $1K | 4.98% |
| R&R INSURANCE SERVICE INC3 Filed as: R & R INSURANCE SERVICE INC | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $70 | $1K | 4.38% |
| BLOCK, CHARLES, D3 | 648 VILLAGE PARK DRIVE UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $315 | — | $315 | 1.11% |
| VAN EPPS, JAMES, H3 | 10930 CRABAPPLE ROAD SUITE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $315 | — | $315 | 1.11% |
| R & R INSURANCE SERVICES INC3 | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $490 | $5K | 17.75% |
| CARUTH, JENNON, M3 | 7825 WASHINGTON AVENUE SOUTH SUITE 710 BLOOMINGTON, MN 55439 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $510 | $32 | $542 | 21.06% |
| R & R INSURANCE SERVICES INC3 | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $326 | $21 | $347 | 13.49% |
| ASSUREX3 | 175 SOUTH 3RD STREET SUITE 800 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $18 | $18 | 0.70% |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORAT | 75 | $977K |
| Dental | HUMANA INSURANCE COMPANY | 73 | $96K |
| Vision | HUMANA INSURANCE COMPANY | 73 | $96K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 94 | $59K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 94 | $33K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 94 | $33K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 315 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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."
No prospect flags tripped on this filing.