| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICE | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 5.76% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICE | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 5.31% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC - MN | 901 MARQUETTE AVE STE 1800 MINNEAPOLIS, MN 55402 | METROPOLITIAN LIFE INSURANCE COMPANY | — | $8K | $8K | 9.30% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICE | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 17.76% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICE | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 9.80% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $872 | — | $872 | 4.58% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 1103 HUNTER DRIVE STE 100 MOUNT PLEASANT, WI 53406 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $130 | — | $130 | 2.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | 5901 LINCOLN DRIVE MINNEAPOLIS, MN 55436 | $375K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 2801 HOOVER RD. PO BOX 828 STEVENS POINT, WI 54881 | $31K |
| HAYS COMPANIES INC EIN 41-1932108 BROKER | Other commissions Service code 55 | 1200 N. MAYFAIR RD. STE 100 MILWAUKEE, WI 53226 | $4K |
| BROWN & BROWN INS SVC, INC. BROKER | Insurance agents and brokers Service code 22 | 1200 N. MAYFAIR ROAD STE 100 MILWAUKEE, WI 53226 | $682 |
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 | 661 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 672 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | METROPOLITIAN LIFE INSURANCE COMPANY | 1,172 | $89K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 661 | $128K |
| Short-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $157K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 558 | $160K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 1,035 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,172 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.