| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRICIA FRETT3 Filed as: PATRICIA M. FRETT | N14 W23900 STONE RIDGE DR. WAUKESHA, WI 53188 | WPS HEALTH PLAN, INC. | $31K | — | $31K | 3.50% |
| PATRICIA FRETT3 Filed as: PATRICIA M. FRETT | N14 W23900 STONE RIDGE DR. WAUKEHSA, WI 53188 | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | $17K | — | $17K | 2.50% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES INC | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $14K | — | $14K | 7.38% |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WPS HEALTH PLAN, INC. | 143 | $1.6M |
| Dental | BLUE CROSS BLUE SHIELD OF WISCONSIN | 293 | $187K |
| Vision | BLUE CROSS BLUE SHIELD OF WISCONSIN | 293 | $187K |
| Life insurance | BLUE CROSS BLUE SHIELD OF WISCONSIN | 293 | $187K |
| Short-term disability | BLUE CROSS BLUE SHIELD OF WISCONSIN | 293 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.