| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRICOR LLC3 | PO BOX 450 LANCASTER, WI 53813 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | — | $12K | 13.18% |
| THE WORKSITE GROUP LLC3 | 1900 POLARIS PARKWAY SUITE 450 COLUMBUS, OH 43240 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 12.00% |
| TRICOR LLC3 Filed as: TRICOR, INC | 230 W CHERRY ST LANCASTER, WI 53813 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 6.00% |
| THIRD COAST ADVISORS INC3 | 1166 QUAIL CT #100 PEWAUKEE, WI 53072 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $23 | — | $23 | 0.06% |
| TRICOR LLC3 | 230 W CHERRY ST LANCASTER, WI 53813 | WYSSTA INSURANCE COMPANY INC | $2K | — | $2K | 8.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRAIRIE STATES ENTERPRISES, INC CLAIM PROCESSING | Claims processing Service code 12 | 35 EAST WACKER DRIVE SUITE 3200 CHICAGO, IL 60601 | $184K |
| PHCS EIN 39-1634080 CLAIMS PROCESSING | Other insurance fees and expenses; Claims processing Service code 12 | — | $44K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 TPA (DENTAL BENEFIT) | Contract Administrator Service code 13 | — | $9K |
| TRICOR LLC INSURANCE AGENT OR BROKER | Insurance agents and brokers Service code 22 | 230 W CHERRY ST LANCASTER, WI 53813 | $2K |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 0 | $25K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 0 | $93K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 0 | $93K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 0 | $706K |
| Other(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 0 | $744K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.