| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES INC | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $319 | $3K | 5.58% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES INC. | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $669 | $669 | 1.75% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES INC. | PO BOX 1610 WAUKESHA, WI 531871610 | WYSSTA INSURANCE COMPANY INC. | $1K | — | $1K | 8.42% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES INC. | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $128 | $2 | $130 | 2.36% |
| ASSUREX3 | SUITE 800, 175 SOUTH 3RD STREET COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $1 | $1 | 0.02% |
No Schedule C service providers reported on this filing.
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 | 179 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC. | 102 | $12K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 179 | $93K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 179 | $38K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 179 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.