No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUCENT HEALTH SOLUTIONS EIN 39-1997579 THIRD PARTY ADMINSTRATOR | Contract Administrator Service code 13 | 5560 W GRANDE MARKET DR APPLETON, WI 54913 | $57K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINSTRATOR | Contract Administrator Service code 13 | 2801 HOOVER ROAD, P.O. BOX 828 STEVENS POINT, WI 54481 | $11K |
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 | 252 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPANION LIFE COLUMBIA, SC | 217 | $213K |
| Vision | WYSSTA INSURANCE COMPANY, INC. | 169 | $22K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 252 | $31K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 252 | $17K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 252 | $40K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE COLUMBIA, SC | 217 | $213K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 252 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 252 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.