| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT SERVICES GROUP, INC.3 Filed as: BENEFIT SERVICES GROUP | PO BOX 78117 MILWAUKEE, WI 532780117 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $72K | — | $72K | 2.96% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP | N25 W23050 PAUL ROAD PEWAUKEE, WI 53072 | UNITY HEALTH PLANS INSURANCE CORPORATION | $15K | — | $15K | 3.58% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC | PO BOX 78117 MILWAUKEE, WI 53278 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $43K | — | $43K | 12.54% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE-SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $143 | $143 | 0.04% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP | PO BOX 78117 MILWAUKEE, WI 53278 | DELTA DENTAL OF WISCONSIN | $21K | — | $21K | 6.30% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: BENEFIT SERVICES GROUP | N25 W23050 PAUL ROAD PEWAUKEE, WI 53072 | SELECTHEALTH | $8K | — | $8K | 4.04% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: BENEFIT SERVICES GROUP INC | PO BOX 78117 MILWAUKEE, WI 53278 | HUMANA INSURANCE COMPANY | $1K | — | $1K | 1.69% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP | PO BOX 78117 MILWAUKEE, WI 53278 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | $4K | — | $4K | 8.75% |
| M BARRINGTON CORPORATION3 Filed as: M BARRINGTON CORP | 4425 N. PORT WASHINGTON RD-STE 105 GLENDALE, WI 53212 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $579 | $5K | 11.31% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC | PO BOX 78117 MILWAUKEE, WI 53278 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 8.57% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS INC. | 1125 NW COUCH ST.-SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $1K | $1K | 2.87% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: BENEFIT SERVICES GROUP | PO BOX 78117 MILWAUKEE, WI 53278 | CARE-PLUS MANAGED CARE DENTAL PLANS | $1K | — | $1K | 5.00% |
| M BARRINGTON CORPORATION3 Filed as: M. BARRINGTON CORP. | 4425 N. PORT WASHINGTON RD-STE 105 GLENDALE, WI 53212 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $811 | $120 | $931 | 11.84% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC. | PO BOX 78117 MILWAUKEE, WI 53278 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $699 | — | $699 | 8.89% |
| M FINANCIAL HOLDINGS INC3 Filed as: M. FINANCIAL HOLDINGS | 1125 NW COUCH STREET - SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $229 | $229 | 2.91% |
| M BARRINGTON CORPORATION3 Filed as: M BARRINGTON CORP | 4425 N. PORT WASHINGTON RD-STE 105 GLENDALE, WI 53212 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $450 | $9 | $459 | 9.00% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC | PO BOX 78117 MILWAUKEE, WI 53278 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $386 | — | $386 | 7.57% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS INC. | 1125 NW COUCH ST-SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $105 | $105 | 2.06% |
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 | 469 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 53 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 28 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 550 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 561 | $3.1M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 355 | $359K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 796 | $45K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 469 | $341K |
| Long-term disability(4 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 469 | $398K |
| Prescription drug(2 contracts, 2 carriers) | UNITY HEALTH PLANS INSURANCE CORPORATION | 137 | $518K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 796 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.