| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 400 N EXECUTIVE DRIVE STE 300 BROOKFIELD, WI 53005 | QUARTZ HEALTH BENEFIT PLANS COPORATION | $32K | — | $32K | 3.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 5.76% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 400 N EXECUTIVE DRIVE STE 300 BROOKFIELD, WI 53005 | HARTFORD LIFE AND ACCIDENT | $8K | — | $8K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 S FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | $838 | $838 | 1.57% |
| VARIOUS - SEE ATTACHED3 Filed as: MULTIPLE AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $4K | $28 | $4K | 16.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | WYSSTA INSURANCE COMPANY INC | $478 | — | $478 | 5.40% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 93033 NETWORK PL CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $897 | — | $897 | 12.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | 93033 NETWORK PL CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $242 | — | $242 | 14.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | 93033 NETWORK PL CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $125 | — | $125 | 14.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | 93033 NETWORK PL CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $27 | — | $27 | 15.00% |
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 | 180 | 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) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | QUARTZ HEALTH BENEFIT PLANS COPORATION | 153 | $1.0M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 94 | $84K |
| Vision | WYSSTA INSURANCE COMPANY INC | 77 | $9K |
| Life insurance(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 171 | $77K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 27 | $24K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 171 | $53K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS COPORATION | 153 | $1.0M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 171 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.