| 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 | $160K | — | $160K | 4.79% |
| INGENIUM PRIME INC3 Filed as: INGENIUM PRIME, INC. | N25 W23050 PAUL ROAD PEWAUKEE, WI 530720000 | DELTA DENTAL OF WISCONSIN | $29K | — | $29K | 6.68% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC | PO BOX 78117 MILWAUKEE, WI 53278 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $69K | — | $69K | 16.76% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE-SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $165 | $165 | 0.04% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP | PO BOX 88911 MILWAUKEE, WI 53288 | UNITY HEALTH PLANS INSURANCE CORPORATION | $15K | — | $15K | 4.37% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: BENEFIT SERVICES GROUP | N25 W23050 PAUL ROAD PEWAUKEE, WI 53072 | SELECTHEALTH | $10K | — | $10K | 3.81% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP | PO BOX 78117 MILWAUKEE, WI 53278 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | $5K | — | $5K | 9.89% |
| M BARRINGTON CORPORATION3 Filed as: M BARRINGTON CORP | 4425 N. PORT WASHINGTON RD-STE 105 GLENDALE, WI 53212 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $11 | $2K | 6.25% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC | PO BOX 78117 MILWAUKEE, WI 53278 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.66% |
| 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 | — | $819 | $819 | 2.23% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: BENEFIT SERVICES GROUP | PO BOX 78117 MILWAUKEE, WI 53278 | CARE-PLUS DENTAL PLANS, INC. | $2K | — | $2K | 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 | $426 | $1 | $427 | 5.44% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC. | PO BOX 78117 MILWAUKEE, WI 53278 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $311 | — | $311 | 3.96% |
| M FINANCIAL HOLDINGS INC3 Filed as: M. FINANCIAL HOLDINGS | 1125 NW COUCH STREET - SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $155 | $155 | 1.97% |
| M BARRINGTON CORPORATION3 Filed as: M BARRINGTON CORP | 4425 N. PORT WASHINGTON RD-STE 105 GLENDALE, WI 53212 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $385 | $3 | $388 | 7.09% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC | PO BOX 78117 MILWAUKEE, WI 53278 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $325 | — | $325 | 5.94% |
| 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 | — | $123 | $123 | 2.25% |
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 | 520 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 530 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 609 | $3.9M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 395 | $468K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 956 | $47K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 520 | $410K |
| Long-term disability(4 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 520 | $460K |
| Prescription drug | UNITY HEALTH PLANS INSURANCE CORPORATION | 130 | $334K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 520 | $410K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 956 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.