| 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 | $158K | — | $158K | 4.40% |
| INGENIUM PRIME INC3 Filed as: INGENIUM PRIME, INC. | N25 W23050 PAU ROAD PEWAUKEE, WI 530720000 | DELTA DENTAL OF WISCONSIN | $26K | — | $26K | 5.67% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP | PO BOX 88911 MILWAUKEE, WI 53288 | UNITY HEALTH PLANS INSURANCE CORPORATION | $14K | — | $14K | 3.08% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC | PO BOX 78117 MILWAUKEE, WI 53278 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $75K | — | $75K | 17.12% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE-SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $192 | $192 | 0.04% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: BENEFIT SERVICES GROUP | N25 W23050 PAUL ROAD PEWAUKEE, WI 53072 | SELECTHEALTH | $13K | — | $13K | 4.12% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP | PO BOX 78117 MILWAUKEE, WI 53278 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | $6K | — | $6K | 10.00% |
| M BARRINGTON CORPORATION3 Filed as: M BARRINGTON CORP | 4425 N. PORT WASHINGTON RD-STE 105 GLENDALE, WI 53212 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $158 | $3K | 6.41% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC | PO BOX 6762 CAROL STREAM, IL 60197 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $12 | $2K | 4.62% |
| 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 | — | $4 | $4 | 0.01% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: BENEFIT SERVICES GROUP | PO BOX 6762 CAROL STREAM, IL 60197 | 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 | $600 | $93 | $693 | 8.34% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC. | PO BOX 6762 CAROL STREAM, IL 60197 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $477 | $1 | $478 | 5.75% |
| M FINANCIAL HOLDINGS INC3 Filed as: M. FINANCIAL HOLDINGS | 1125 NW COUCH STREET - SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $194 | $194 | 2.34% |
| M BARRINGTON CORPORATION3 Filed as: M BARRINGTON CORP | 4425 N. PORT WASHINGTON RD-STE 105 GLENDALE, WI 53212 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $373 | $18 | $391 | 6.37% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC | PO BOX 6762 CAROL STREAM, IL 60197 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $310 | $3 | $313 | 5.10% |
| 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 | — | $125 | $125 | 2.04% |
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 | 561 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 585 | 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 | 675 | $4.4M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 417 | $486K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 958 | $60K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 561 | $436K |
| Long-term disability(4 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 561 | $490K |
| Prescription drug | UNITY HEALTH PLANS INSURANCE CORPORATION | 122 | $448K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 561 | $436K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 958 | — |
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.