| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 FINANCIAL LLC3 | 828 JOHN NOLEN DR MADISON, WI 53713 | METROPOLITAN LIFE INSURANCE COMPANY | $18K | — | $18K | 13.72% |
| SECURA CONSULTANTS LLC3 | 6465 WAYZATA BLVD STE 920 MINNEAPOLIS, MN 55426 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | — | $12K | 9.11% |
| GEORGE DAVIDSON3 | 31 SMITH ST STE 304 CHARLESTON, SC 29401 | METROPOLITAN LIFE INSURANCE COMPANY | $437 | — | $437 | 0.33% |
| BENEFITSTORE INC3 | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | HARTFORD LIFE AND ACCIDENT | $45K | — | $45K | 39.64% |
| HAYS COMPANIES, INC.3 | 80 SO. 8TH ST. STE. 700 MINNEAPOLIS, MN 554022105 | VISION SERVICE PLAN | $1K | — | $1K | 1.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF WI EIN 39-0138065 NONE | Claims processing; Other services; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | — | $304K |
| WISCONSIN COLLABORATIVE INSURANCE C EIN 47-5569628 NONE | Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other fees; Other services Service code 12 | — | $295K |
| BLUE CROSS BLUE SHIELD OF WISCONSIN | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | — | $143K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 NONE | Insurance brokerage commissions and fees; Contract Administrator; Other commissions; Insurance agents and brokers Service code 13 | — | $46K |
| CVS PHARMACY, INC. EIN 05-0340626 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $22K |
| WEX HEALTH, INC. EIN 06-1593514 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $20K |
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 | 2,247 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 351 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,598 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,247 | $143K |
| Vision | VISION SERVICE PLAN | 923 | $113K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,141 | $181K |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 591 | $175K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF WISCONSIN | 1,810 | $909K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,247 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,247 | — |
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.