| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES, INC. | N14W23900 STONE RIDGE DR. WAUKESHA, WI 531881135 | HCC LIFE INSURANCE COMPANY | $14K | — | $14K | 5.00% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES, INC. | N14W23900 STONE RIDGE DR. WAUKESHA, WI 53188 | HCC LIFE INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES, INC. | PO BOX 1610 WAUKESHA, WI 53187 | DELTA DENTAL OF WISCONSIN | $6K | — | $6K | 6.91% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES, INC. | N14W23900 STONE RIDGE DR. WAUKESHA, WI 531881135 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | $1K | — | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $98K |
| R&R INSURANCE SERVICES EIN 39-1230987 BROKER | Other commissions Service code 55 | W239 N3490 STONE RIDGE DRIVE WAUKESHA, WI 53188 | $15K |
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $2K |
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 | 127 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | HCC LIFE INSURANCE COMPANY | 147 | $379K |
| Dental | DELTA DENTAL OF WISCONSIN | 99 | $87K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 82 | $12K |
| Stop-loss / reinsurancereinsurance(2 contracts) | HCC LIFE INSURANCE COMPANY | 147 | $379K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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.