| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | SUN LIFE ASSURANCE COMPANY OF CANADA | $51K | — | $51K | 5.00% |
| LOCKTON COMPANIES, LLC3 | 4275 EXECUTIVE SQUARE, SUITE 600 LA JOLLA, CA 92037 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $28K | $28K | 2.81% |
| BURKART ASSOCIATES, LTD3 | 118 STAFFORD STREET, PO BOX 197 PLYMOUTH, WI 53073 | AETNA LIFE INSURANCE CO. | $51K | — | $51K | 5.25% |
| BURKART ASSOCIATES, LTD3 | 1807 ERIE AVENUE SHEBOYGAN, WI 53081 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | $7K | — | $7K | 5.06% |
| FLANAGAN INSURANCE3 | 124 EAST MILL STREET PLYMOUTH, WI 53073 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREVEA HEALTH CLINIC EIN 39-1839349 ON-SITE CLINIC | Other services Service code 49 | — | $1.2M |
| PRAIRIE STATES ENTERPRISES, INC. ADMINISTRATOR | Contract Administrator Service code 13 | 35 EAST WACKER DR, 3200 312-464-1888 CHICAGO, IL 60601 | $608K |
| NAVITUS HEALTH SOLUTIONS, LLC EIN 04-3608530 ADMINISTRATOR | Contract Administrator Service code 13 | — | $113K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $77K |
| JACK BURKART BURKART ASSOCIATES LTD BROKER | Insurance agents and brokers Service code 22 | PO BOX 197 PLYMOUTH, WI 53073 | $13K |
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 | 2,070 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,091 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 2,273 | $131K |
| Life insurance | AETNA LIFE INSURANCE CO. | 1,961 | $965K |
| Long-term disability | AETNA LIFE INSURANCE CO. | 1,961 | $965K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,602 | $1.0M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 1,961 | $981K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,273 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.