No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 SERVICE PROVIDER | Contract Administrator; Claims processing Service code 12 | 11 SCOTT STREET WAUSAU, WI 544021087 | $176K |
| COALITION SERVICES, LLC EIN 46-3105185 SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general) Service code 15 | P.O. BOX 561 BROOKFIELD, WI 530080561 | $60K |
| XEROX CARE & QUALITY SOLUTIONS EIN 39-1677922 SERVICE PROVIDER | Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 9779 SOUTH FRANKLIN AVENUE SUITE 300 FRANKLIN, WI 53132 | $30K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 SERVICE PROVIDER | Claims processing; Contract Administrator Service code 12 | 2801 HOOVER ROAD P.O. BOX 828 STEVENS POINT, WI 54481 | $21K |
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 | 1,019 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,024 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 286 | $348K |
| Vision | WYSSTA INSURANCE COMPANY, INC. | 555 | $92K |
| Life insurance | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 1,019 | $42K |
| Other | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 1,019 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,019 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.