| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HCC LIFE INSURANCE COMPANY | — | $62K | $62K | 5.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $14K | — | $14K | 1.47% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | HARTFORD LIFE AND ACCIDENT | $4K | — | $4K | 2.01% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $9K | — | $9K | 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 | — | $2.1M |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $879K |
| ASSET HEALTH, INC. EIN 65-1258234 ADMINISTRATOR | Contract Administrator Service code 13 | — | $117K |
| NAVITUS HEALTH SOLUTIONS EIN 04-3608530 ADMINISTRATOR | Plan Administrator; Contract Administrator Service code 13 | — | $104K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $75K |
| MATRIX ABSENCE MANAGEMENT, INC. EIN 77-0493584 CLAIMS PROCESSING | Claims processing Service code 12 | — | $74K |
| ADVOCATE AURORA HEALTH EIN 39-1442285 ADMINISTRATOR | Contract Administrator Service code 13 | — | $58K |
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 | 2,021 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,040 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 1,182 | $182K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,021 | $1.2M |
| Long-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,021 | $1.2M |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,638 | $1.2M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,021 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,021 | — |
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.