| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED FINANCIAL GROUP LLC3 | 12600 WHITEWATER DR MINNETONKA, MN 55343 | ANTHEM LIFE INSURANCE COMPANY | $3K | — | $3K | 5.36% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP OF WI LLC | 1200 NORTH MAYFAIR RD #100 MILWAUKEE, WI 53226 | ANTHEM LIFE INSURANCE COMPANY | $3K | — | $3K | 4.52% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMPCARE HEALTH SERVICES INSURANCE EIN 39-1462554 CLAIMS PROCESSING | Claims processing; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Other services Service code 12 | — | $11K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | — | $5K |
| ANTHONIE GOEDHEER INSURANCE AGENT OR BROKE | Insurance agents and brokers Service code 22 | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 53045 | $62 |
| BLUE CROSS BLUE SHIELD OF WI EIN 39-0138065 CLAIMS PROCESSING | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing Service code 12 | — | $3 |
| INGENIORX, INC. EIN 82-3062245 CLAIMS PROCESSING | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator Service code 12 | — | -$297 |
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 | 105 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 77 | $10K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 223 | $63K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 223 | $63K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 223 | $63K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF WISCONSIN | 13 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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.
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.