| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENECO3 Filed as: BENECO OF WI INC | 250 N PATRICK BLVD STE 100 BROOKFIELD, WI 530455876 | HUMANA HEALTH PLAN, INC. | — | $4K | $4K | 0.38% |
| BENEFITS INC3 Filed as: BENEFITS, INC. | 250 N PATRICK BLVD STE 100 BROOKFIELD, WI 53045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $50K | $9K | $59K | 8.33% |
| BENECO3 Filed as: BENECO OF WISCONSIN | 250 N PATRICK BLVD STE 100 BROOKFIELD, WI 53045 | DELTA DENTAL OF WISCONSIN | $54K | — | $54K | 11.07% |
| BENECO3 Filed as: BENECO OF WISCONSIN | 250 N PATRICK BLVD STE 100 BROOKFIELD, WI 53045 | DELTA DENTAL OF WISCONSIN | $22K | — | $22K | 11.82% |
| BENECO3 Filed as: BENECO OF WISCONSIN | 250 N. PATRICK BLVD., SUITE 100 BROOKFIELD, WI 53045 | WYSSTA INSURANCE COMPANY INC | $13K | — | $13K | 10.00% |
| BENECO3 Filed as: BENECO OF WISCONSIN | 250 N PATRICK BLVD STE 100 BROOKFIELD, WI 53045 | WYSSTA INSURANCE COMPANY INC | $829 | — | $829 | 10.00% |
| BENECO3 Filed as: BENECO OF WISCONSIN | 250 N PATRICK BLVD STE 100 BROOKFIELD, WI 53045 | WYSSTA INSURANCE COMPANY INC | $526 | — | $526 | 10.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HUMANA EIN 39-1263473 NONE | Claims processing Service code 12 | PO BOX 14600 LEXINGTON, KY 40512 | $487K |
| HEALICS, INC. EIN 39-1828314 NONE | Other services Service code 49 | W140N5084 LILLY ROAD MENOMONEE FALLS, WI 53051 | $324K |
| HINES & ASSOCIATES EIN 36-3545085 NONE | Insurance services Service code 23 | 115 EAST HIGHLAND ST. ELGIN, IL 60120 | $101K |
| ALLIANCE HEALTHCARE EIN 39-1675538 NONE | Insurance services Service code 23 | 5510 NOBLE DR. MADISON, WI 53711 | $93K |
| NAVITUS HEALTH SOLUTIONS EIN 04-3608530 NONE | Consulting (general) Service code 16 | 2601 W. BELTLINE HIGHWAY SUITE 600 MADISON, WI 53713 | $76K |
| BENECO EIN 39-1524097 NONE | Contract Administrator Service code 13 | 250 N PATRICK BLVD STE 100 BROOKFIELD, WI 53045 | $45K |
| WIPFLI LLP EIN 39-0758449 NONE | Accounting (including auditing) Service code 10 | — | $17K |
| DIVERSIFIED BENEFIT SERVICES, INC NONE | Other services Service code 49 | PO BOX 260 HARTLAND, WI 53029 | $11K |
| CERIDIAN CORPORATION EIN 41-1981625 NONE | Consulting (general) Service code 16 | 3311 E SHAKOPEE ROAD MINNEAPOLIS, MN 55425 | $8K |
| MIDLANDS CHOICE EIN 47-0804331 NONE | Insurance services Service code 23 | 8420 W. DODGE ROAD OMAHA, NE 68114 | $5K |
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 | 1,306 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,314 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA HEALTH PLAN, INC. | 1,300 | $1.1M |
| Dental(2 contracts) | DELTA DENTAL OF WISCONSIN | 765 | $678K |
| Vision(3 contracts) | WYSSTA INSURANCE COMPANY INC | 1,000 | $140K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,050 | $710K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,050 | $710K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,050 | $710K |
| Stop-loss / reinsurancereinsurance | HUMANA HEALTH PLAN, INC. | 1,300 | $1.1M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,050 | $710K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,050 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.