| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GREAT PLAINS LLC | 4200 UNIVERSITY AVE STE 200 WEST DES MOINES, IA 50266 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | $6K | — | $6K | 0.67% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GREAT PLAINS | 4200 UNIVERSITY AVE STE 200 WEST DES MOINES, IA 50266 | DELTA DENTAL OF WISCONSIN | $13K | — | $13K | 5.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GREAT PLAINS | 4200 UNIVERSITY AVE STE 200 WEST DES MOINES, IA 50266 | WYSSTA INSURANCE COMPANY INC | $1K | — | $1K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMPCARE HEALTH SERVICES INSURANCE EIN 39-1462554 NONE | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Contract Administrator Service code 12 | — | $88K |
| INGENIO RX INC EIN 82-3062245 NONE | Claims processing; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) 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 | 245 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 581 | $863K |
| Dental | DELTA DENTAL OF WISCONSIN | 248 | $257K |
| Vision | WYSSTA INSURANCE COMPANY INC | 161 | $29K |
| Other | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 581 | $863K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 581 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.