| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED FINANCIAL GROUP LLC3 | 6000 CLEARWATER DR MINNETONKA, MN 55343 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $125K | — | $125K | 1.92% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 12600 WHITEWATER DR MINNETONKA, MN 55343 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $35K | $917 | $36K | 0.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 400 HWY 169 SOUTH 8TH FLOOR ST. LOUIS PARK, MN 55426 | BLUE CROSS BLUE SHIELD OF WISCONSIN | -$743 | — | -$743 | -0.01% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GROUP | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | $5K | $12K | 16.16% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 4.00% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GROUP | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $4K | $8K | 18.59% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 4.00% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GROUP | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | $5K | $14K | 158.51% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 40.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF WISCONSIN EIN 39-0138065 CLAIMS PROCESSING | Contract Administrator; Claims processing; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $39K |
| WAGEWORKS EIN 94-3351864 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $9K |
| ASSOCIATED FINANCIAL GROUP LLC INS AGENT OR BROKER | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 711 EISENHOWER DR KIMBERLY, WI 54136 | $0 |
| USI INSURANCE SERVICES NATIONAL INC INS AGENT OR BROKER | Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | 227 W TRADE ST STE 1500 CHARLOTTE, NC 28202 | $0 |
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 | 596 | 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) | 596 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 1,308 | $6.5M |
| Dental | BLUE CROSS BLUE SHIELD OF WISCONSIN | 1,308 | $6.5M |
| Vision | BLUE CROSS BLUE SHIELD OF WISCONSIN | 1,308 | $6.5M |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 704 | $9K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 252 | $46K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 704 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,308 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.