| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IBENEFIT COMMUNICATION LLC3 | 131 HILLSIDE AVE CHARLOTTE, NC 28209 | RELIASTAR LIFE INSURANCE COMPANY | $118K | — | $118K | 10.23% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | RELIASTAR LIFE INSURANCE COMPANY | $85K | — | $85K | 7.41% |
| BSC AGENCY LLC3 | 1025 ASHWORTH RD WEST DES MOINES, IA 50265 | RELIASTAR LIFE INSURANCE COMPANY | — | $30K | $30K | 2.61% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF WI EIN 39-0138065 ADMINISTRATOR | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator Service code 12 | — | $973K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 TPA-DENTAL | Contract Administrator Service code 13 | — | $51K |
| DIVERSIFIED BENEFIT SERVICES INC ADMINISTRATOR | Claims processing Service code 12 | PO BOX 260 HARTLAND, WI 53029 | $12K |
| RELIASTAR LIFE INSURANCE COMPANY EIN 41-0451140 ADMINSTRATOR-EAP | Claims processing Service code 12 | — | $8K |
| COMPCARE HEALTH SERVICES INS EIN 39-1462554 ADMINISTRATOR | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing Service code 12 | — | -$54K |
| INGENIORX EIN 82-3062245 PHARMACY BENEFIT MGMT | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | -$527K |
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 | 2,278 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,291 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY | 1,241 | $140K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 2,291 | $1.2M |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 2,291 | $1.2M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF WISCONSIN | 1,537 | $416K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 2,291 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,291 | — |
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.