| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 93033 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $12K | — | $12K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 93033 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $16K | — | $16K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 775 YARD STREET STE 200 COLUMBUS, OH 43212 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN | $6K | — | $6K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 93033 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $174 | — | $174 | 14.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX EIN 33-0441200 PHARMACY BENEFIT MGMT | Direct payment from the plan; Float revenue; Other fees; Claims processing Service code 12 | — | $2.0M |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $313K |
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 | 691 | 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) | 691 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN | 437 | $61K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 691 | $118K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 687 | $104K |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 465 | $837K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 691 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 691 | — |
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.