| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | HARTFORD LIFE AND ACCIDENT | $15K | $567 | $15K | 5.94% |
| OPTAVISE, LLC3 Filed as: OPTAVISE, INC. | 120 18TH STREET SOUTH BIRMINGTON, AL 35233 | HARTFORD LIFE AND ACCIDENT | $9K | $0 | $9K | 3.36% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC | 227 W MONROE ST SUITE 5200 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | $0 | $4K | $4K | 1.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WPS HEALTH SOLUTIONS EIN 39-1268299 THIRD PARTY CLAIMS ADMIN | Contract Administrator; Claims processing; Recordkeeping fees Service code 12 | 1717 WEST BROADWAY MADISON, WI 53708 | $226K |
| EMPLOYER HEALTHCARE ALLIANCE COOP EIN 39-1675538 CLAIMS REPRICING | Other services Service code 49 | P.O. BOX 44365 MADISON, WI 53744 | $148K |
| UMR, INC. EIN 39-1995276 SERVICE PROVIDER | Claims processing Service code 12 | 150 WEST WAUSAU AVENUE WAUSAU, WI 54401 | $50K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY CLAIMS ADMIN | Claims processing; Contract Administrator Service code 12 | P.O. BOX 86 STEVENS POINT, WI 54481 | $28K |
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 | 875 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 889 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 576 | $86K |
| Life insurance | UNITED HEALTHCARE INSURANCE COMPANY | 875 | $165K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 873 | $254K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 873 | $254K |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 875 | $165K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 875 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.