| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 55 EAST JACKSON BLVD #14A CHICAGO, IL 60604 | WYSSTA INSURANCE COMPANY | $156 | — | $156 | 1.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRAIRIE STATES ENTERPRISES, INC. CLAIMS PROCESSING | Claims processing Service code 12 | 35 EAST WACKER DRIVE SUITE 3200 CHICAGO, IL 60601 | $55K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $7K |
| MARSH & MCLENNAN AGENCY LLC INS AGENTS/ BROKERS | Insurance agents and brokers Service code 22 | 55 EAST JACKSON BLVD #14A CHICAGO, IL 60604 | $1K |
| ALITHIAS CLAIMS PROCESSING | Other insurance fees and expenses; Claims processing Service code 12 | 1101 N MARKET STREET MILWAUKEE, WI 53202 | $0 |
| CLEAR HEALTH CLAIMS PROCESSING | Claims processing; Other insurance fees and expenses Service code 12 | 9990 COCONUT ROAD SUITE 356 BONITA SPRINGS, FL 34135 | $0 |
| FH GROUP CORP EIN 20-1736437 CLAIMS PROCESSING | Other insurance fees and expenses; Claims processing Service code 12 | — | $0 |
| FIRST HEALTH EIN 20-1274723 CLAIMS PROCESSING | Claims processing; Other insurance fees and expenses Service code 12 | — | $0 |
| MULTIPLAN EIN 39-1634080 CLAIMS PROCESING | Other insurance fees and expenses; 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 | 170 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY | 88 | $13K |
| Stop-loss / reinsurancereinsurance | GERBER LIFE INSURANCE COMPANY/MEDICAL RISK MGMT | 100 | $333K |
| Other | NORTH AMERICAN SPECIALTY INS CO/SWISS RE | 100 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 100 | — |
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 prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.