| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CARPENTER ROWLAND BATENBURG CO INC3 | 500 WISCONSIN AVE RACINE, WI 534031051 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | — | $15K | 10.87% |
| CARPENTER ROWLAND BATENBURG CO INC3 | 500 WISCONSIN AVE RACINE, WI 534031051 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 5.25% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | 234 SPRING LAKE DR ITASCA, IL 601433202 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 3.74% |
| CARPENTER ROWLAND BATENBURG CO INC3 Filed as: CARPENTER ROWLAND BATENBURG | 500 WISCONSIN AVE 1ST FL RACINE, WI 53403 | WYSSTA INSURANCE COMPANY INC | $4K | — | $4K | 8.00% |
| CARPENTER ROWLAND BATENBURG CO INC3 | 500 WISCONSIN AVE RACINE, WI 534031051 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 10.26% |
| BOON ADMINISTRATIVE SERVICES5 | 234 SPRING LAKE DR ITASCA, IL 601433202 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 5.01% |
| CARPENTER ROWLAND BATENBURG CO INC3 | 500 WISCONSIN AVE RACINE, WI 534031051 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 6.77% |
| BOON ADMINISTRATIVE SERVICES5 | 234 SPRING LAKE DR ITASCA, IL 601433202 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 5.77% |
| CARPENTER ROWLAND BATENBURG CO INC3 | 500 WISCONSIN AVE RACINE, WI 534031051 | METROPOLITAN LIFE INSURANCE COMPANY | $647 | — | $647 | 3.10% |
| BOON ADMINISTRATIVE SERVICES5 | 234 SPRING LAKE DR ITASCA, IL 601433202 | METROPOLITAN LIFE INSURANCE COMPANY | — | $552 | $552 | 2.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR,INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $298K |
| LOCKTON COMPANIES,LLC EIN 20-3354970 BROKER | Other commissions Service code 55 | — | $120K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMIN | Contract Administrator Service code 13 | — | $18K |
| CARPENTER ROWLAND BATENBURG INS AGENT OR BROKER | Insurance agents and brokers Service code 22 | 500 WISCONSIN AVE 1ST FL RACINE, WI 53403 | $5K |
| RXBENEFITS, INC. EIN 63-1157085 CLAIMS PROCESSING | Claims processing Service code 12 | — | $3K |
| THE HEALTH PLAN OF THE UPPER OHIO EIN 55-0585592 RECORDKEEPING | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $600 |
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 | 458 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 477 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 285 | $55K |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 757 | $275K |
| Short-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 462 | $190K |
| Long-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 757 | $275K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 333 | $969K |
| Other(5 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 757 | $356K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 757 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.