| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R & R INSURANCE SERVICES INC3 Filed as: R & R INSURANCE SERVICES, INC | 1581 EAST RACINE AVENUE WAUKESHA, WI 53186 | TOKIO MARINE | $12K | — | $12K | 2.81% |
| R & R INSURANCE SERVICES INC3 Filed as: R & R INSURANCE SERVICES, INC. | PO BOX 1610 WAUKESHA, WI 53187 | DELTA DENTAL OF WISCONSIN | $6K | — | $6K | 5.92% |
| R & R INSURANCE SERVICES INC3 Filed as: R & R INSURANCE SERVICES, INC. | 1581 E RACINE AVE WAUKESHA, WI 53186 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 3.78% |
| R & R INSURANCE SERVICES INC3 Filed as: R & R INSURANCE SERVICES, INC. | 1581 E RACINE AVE WAUKESHA, WI 53186 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 5.88% |
| R & R INSURANCE SERVICES INC3 Filed as: R & R INSURANCE SERVICES, INC. | PO BOX 1610 WAUKESHA, WI 53187 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $2K | — | $2K | 10.00% |
| R & R INSURANCE SERVICES INC3 Filed as: R & R INSURANCE SERVICES, INC. | PO BOX 1610 WAUKESHA, WI 53187 | DELTA DENTAL OF WISCONSIN | $120 | — | $120 | 5.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $135K |
| R&R INSURANCE SERVICES INC EIN 39-1230987 BROKER | Other commissions Service code 55 | 1581 E RACINE AVE WAUKESHA, WI 53186 | $15K |
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 | 269 | 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) | 269 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF WISCONSIN | 168 | $95K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 162 | $15K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 269 | $92K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 270 | $66K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 199 | $428K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 269 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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.