| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B ST 6TH FL SAN DIEGO, CA 921018101 | RELIASTAR LIFE INSURANCE COMPANY | $20K | — | $20K | 0.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MGMT | Other fees; Float revenue; Claims processing; Direct payment from the plan Service code 12 | — | $33.2M |
| BCBS OF WISCONSIN EIN 39-0138065 CLAIMS PROCESSING | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue; Other services Service code 12 | — | $4.2M |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | — | $174K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $56K |
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 | 8,820 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 255 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,075 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | METROPOLITAN LIFE INSURANCE COMPANY | 3,737 | $718K |
| Vision(5 contracts) | EYEMED VISION CARE | 8,497 | $532K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 24,997 | $3.0M |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 6,278 | $2.8M |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 24,997 | $3.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 24,997 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.