| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R & R INSURANCE SERVICES INC3 | N14W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $737 | $3K | 20.48% |
| R & R INSURANCE SERVICES INC4 | N14 W23900 STONE RIDGE DR WAUKESHA, WI 53188 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| R & R INSURANCE SERVICES INC | N14 W23900 STONE RIDGE DR WAUKESHA, WI 53188 | WYSSTA INSURANCE COMPANY INC | $796 | — | $796 | 7.90% |
| R & R INSURANCE SERVICES INC3 | N14W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $501 | $4K | 42.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $6K |
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 | 261 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 261 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 73 | $10K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 198 | $23K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 35 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.