| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OPTUMRX, INC.5 Filed as: OPTUMRX, INC | 11000 OPTUM CIR EDEN PRAIRIE, MN 55344 | COMPANION LIFE INSURANCE COMPANY | — | $125K | $125K | 47.19% |
| UMR, INC.5 Filed as: UMR INC. | PO BOX 1087 WAUSAU, WI 54402 | COMPANION LIFE INSURANCE COMPANY | — | $33K | $33K | 12.68% |
| INFINITY BENEFIT SOLUTIONS INC3 Filed as: INFINITY BENEFIT SOLUTIONS INC. | 1036 W JUNEAU AVE, STE 302 MILWAUKEE, WI 53233 | COMPANION LIFE INSURANCE COMPANY | $19K | — | $19K | 7.19% |
| INFINITY BENEFIT SOLUTIONS INC3 Filed as: INFINITY BENEFIT SOLUTIONS INC. | 1036 W JUNEAU AVE, STE 302 MILWAUKEE, WI 53233 | DELTA DENTAL OF WISCONSIN | $4K | — | $4K | 7.93% |
| INFINITY BENEFIT SOLUTIONS INC3 Filed as: INFINITY BENEFIT SOLUTIONS INC. | 1036 W JUNEAU AVE, STE 302 MILWAUKEE, WI 53233 | WYSSTA INSURANCE COMPANY INC | $593 | — | $593 | 8.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC EIN 33-0441200 PHARMACY BENEFIT MANAGER | Direct payment from the plan; Claims processing; Float revenue; Other fees Service code 12 | — | $125K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $33K |
| INFINITY BENEFIT SOLUTIONS INC. EIN 46-0991049 BROKER | Other commissions Service code 55 | — | $19K |
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 | 74 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 74 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPANION LIFE INSURANCE COMPANY | 54 | $264K |
| Dental | DELTA DENTAL OF WISCONSIN | 50 | $45K |
| Vision | WYSSTA INSURANCE COMPANY INC | 51 | $7K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 54 | $264K |
| Prescription drug | COMPANION LIFE INSURANCE COMPANY | 54 | $264K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 54 | $264K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 54 | — |
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.