See the carriers, broker commissions and premiums for this plan.
It also shows filing history and funding margin. Your first month is $4.99.
See 6 contract rows with premium, retention and renewal dates. $4.99 for your first month.
Solo adds 10-year history, peer benchmarks, provider and welfare analytics, saves, and exports. Then $34.99 a month.
See commissions and fees for 5 broker rows. $4.99 for your first month.
Solo adds 10-year history, peer benchmarks, provider and welfare analytics, saves, and exports. Then $34.99 a month.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC EIN 33-0441200 PHARMACY BENEFIT MANAGEM | Claims processing; Float revenue; Other fees; Direct payment from the plan Service code 12 | — | $327K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $213K |
| LOCKTON COMPANIES LLC EIN 20-3354970 BROKER | Other commissions Service code 55 | — | $90K |
| THE HEALTH PLAN OF THE UPPER OHIO EIN 55-0585592 RECORDKEEPING | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $23K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMIN | Contract Administrator Service code 13 | — | $12K |
| CARPENTER ROWLAND BATENBURG INSURANCE AGENT/BROKER | Insurance agents and brokers Service code 22 | 500 WISCONSIN AVE RACINE, WI 53403 | $3K |
| OPTUMRX, INC. | Float revenue; Claims processing; Direct payment from the plan; Other fees 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 | 390 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 393 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 161 | $26K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 350 | $45K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 68 | $25K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 350 | $18K |
| Stop-loss / reinsurancereinsurance | NATIONAL UNION FIRE INS CO | 269 | $379K |
| Other(4 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 350 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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."
The primary carrier changed from the prior filing. The plan is willing to move. Re-pitch on the next cycle.