| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 | 6952 ROTE RD ROCKFORD, IL 61112 | SUN LIFE ASSURANCE COMPANY OF CANADA | $18K | — | $18K | 3.03% |
| WATCHTOWER TECHNOLOGIES INC3 | 306 W ERIE ST SUITE 300 CHICAGO, IL 60654 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 1.49% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 0.99% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DR MADISON, WI 53713 | HARTFORD LIFE AND ACCIDENT | $18K | $2K | $20K | 19.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS & BLUE SHIELD OF WISCONS EIN 39-0138065 SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing; Other services Service code 12 | — | $94K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | — | $11K |
| MATT BORAY INSURANCE AGENT OR BROKE | Insurance agents and brokers Service code 22 | N19 W24200 RIVERWOOD DR STE 140 WAUKESHA, WI 531880000 | $91 |
| COMPCARE HEALTH SERVICES INSURANCE EIN 39-1462554 SERVICE PROVIDER | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $0 |
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 | 191 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 144 | $15K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 372 | $101K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 372 | $101K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 199 | $597K |
| Other | HARTFORD LIFE AND ACCIDENT | 372 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 372 | — |
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.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.