| 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 | $55K | — | $55K | 4.57% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $18K | $18K | 1.50% |
| BURKART ASSOCIATES, LTD3 | 118 STAFFORD STREET, PO BOX 197 PLYMOUTH, WI 53073 | AETNA LIFE INSURANCE CO. | $32K | — | $32K | 2.79% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | AETNA LIFE INSURANCE CO. | $20K | — | $20K | 1.79% |
| BURKART ASSOCIATES, LTD3 | 1807 ERIE AVENUE SHEBOYGAN, WI 53081 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $6K | — | $6K | 3.66% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $2K | — | $2K | 1.34% |
| FLANAGAN INSURANCE3 | 124 EAST MILL STREET PLYMOUTH, WI 53073 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MARATHON HEALTH EIN 27-0746725 ON-SITE CLINIC | Other services Service code 49 | — | $1.6M |
| PRAIRIE STATES ENTERPRISES, INC. ADMINISTRATOR | Contract Administrator Service code 13 | 35 EAST WACKER DR, 3200 312-464-1888 CHICAGO, IL 60601 | $618K |
| NAVITUS HEALTH SOLUTIONS, LLC EIN 04-3608530 ADMINISTRATOR | Plan Administrator; Contract Administrator Service code 13 | — | $336K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $89K |
| LOCKTON COMPANIES, LLC BROKER | Insurance agents and brokers Service code 22 | 444 W. 47TH STREET, 900 KANSAS CITY, MO 64112 | $10K |
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 | 2,243 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 33 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 1,066 | $172K |
| Life insurance | AETNA LIFE INSURANCE CO. | 2,071 | $1.1M |
| Long-term disability | AETNA LIFE INSURANCE CO. | 2,071 | $1.1M |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,704 | $1.2M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 2,071 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,071 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.