| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KELLER & ASSOCIATES BEN PLANNING3 Filed as: KELLER & ASSOC BENEFIT PLANNING | 1025 W GLEN OAKS LN STE 104 MEQUON, WI 53092 | DELTA DENTAL OF WISCONSIN | $14K | — | $14K | 4.01% |
| KELLER & ASSOCIATES BEN PLANNING3 Filed as: KELLER & ASSOCIATES BENEFIT PLANNIN | 1025 WEST GLEN OAKS LANE, SUITE 104 MEQUON, WI 53092 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 6.26% |
| KELLER & ASSOCIATES BEN PLANNING3 Filed as: KELLER & ASSOCIATES BENEFIT PLANNIN | 1025 W GLEN OAKS STE 104 MEQUON, WI 53092 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 10.79% |
| KELLER & ASSOCIATES BEN PLANNING3 Filed as: KELLER & ASSOC BENEFIT PLANNING | 1025 W GLEN OAKS LN STE 104 MEQUON, WI 53092 | WYSSTA INSURANCE COMPANY INC | $4K | — | $4K | 8.05% |
| KELLER & ASSOCIATES BEN PLANNING3 Filed as: KELLER & ASSOCIATES BENEFIT PLANNIN | 1025 W GLEN OAKS LN STE 104 MEQUON, WI 53092 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 8.99% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF WI | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | QBE INSURANCE CORPORATION | $5K | — | $5K | 10.00% |
| KELLER & ASSOCIATES BEN PLANNING3 Filed as: KELLER & ASSOCIATES BENEFIT PLANNIN | 1025 W GLEN OAKS LN STE 104 MEQUON, WI 53092 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX EIN 33-0441200 PHARMACY BENEFIT MGMT | Direct payment from the plan; Float revenue; Other fees; Claims processing Service code 12 | — | $674K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $234K |
| HAYS COMPANIES OF WI EIN 41-1932108 BROKER | Other commissions Service code 55 | — | $60K |
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 | 466 | 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) | 466 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 419 | $351K |
| Vision | WYSSTA INSURANCE COMPANY INC | 318 | $50K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 466 | $88K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 466 | $73K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 466 | $50K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 466 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 466 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.