| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GREAT PLAINS | 4200 UNIVERSITY AVE STE 200 WEST DES MOINES, IA 50266 | DELTA DENTAL OF WISCONSIN | $14K | — | $14K | 5.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GREAT PLAINS | 4200 UNIVERSITY AVE STE 200 WEST DES MOINES, IA 50266 | WYSSTA INSURANCE COMPANY INC | $2K | — | $2K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMPCARE HEALTH SERVICES INSURANCE EIN 39-1462554 ADMINSTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Contract Administrator; Float revenue Service code 12 | — | $233K |
| CARELONRX INC EIN 82-3062425 PRESCRIPTION DRUG | 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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | 282 | $248K |
| Dental | DELTA DENTAL OF WISCONSIN | 274 | $285K |
| Vision | WYSSTA INSURANCE COMPANY INC | 183 | $32K |
| Other | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 268 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 282 | — |
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.