| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC. | 93033 NETWORK PLACE CHICAGO, IL 60673 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $7K | $7K | 1.67% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CALIFO | 525 MARKET ST SUITE 3400 SAN FRANCISCO, WI 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $8K | $8K | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC. | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $2K | $2K | 1.10% |
| DAVID INSURANCE AGENCY INC3 | 1300 S. GREEN BAY RD RACINE, WI 53406 | HARTFORD LIFE AND ACCIDENT | $582 | $19 | $601 | 15.51% |
No Schedule C service providers reported on this filing.
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 | 284 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 388 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 672 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 299 | $38K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 322 | $408K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 322 | $408K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 249 | $194K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 322 | $417K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 322 | — |
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.