| 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 | $64K | — | $64K | 4.59% |
| UMR, INC.3 | 11 SCOTT STREET, SUITE 100 WAUSAU, WI 54403 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $9K | $9K | 0.66% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | HARTFORD LIFE AND ACCIDENT | $58K | — | $58K | 5.50% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $11K | — | $11K | 5.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | HARTFORD FIRE INSURANCE COMPANY | $479 | — | $479 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MARATHON HEALTH EIN 27-0746725 ON-SITE CLINIC | Other services Service code 49 | — | $2.0M |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $933K |
| ADVOCATE AURORA HEALTH EIN 39-1442285 ADMINISTRATOR | Contract Administrator Service code 13 | — | $350K |
| ASSET HEALTH EIN 65-1258234 ADMINISTRATOR | Contract Administrator Service code 13 | — | $115K |
| NAVITUS HEALTH SOLUTIONS, LLC EIN 04-3608530 ADMINISTRATOR | Contract Administrator; Plan Administrator Service code 13 | — | $108K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $87K |
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 | 2,073 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,090 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 1,170 | $221K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,480 | $1.1M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,480 | $1.1M |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,676 | $1.4M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,480 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,480 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.