| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS INC3 | 250 N. PATRICK ROAD STE 100 BROOKFIELD, WI 53045 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $26K | — | $26K | 0.96% |
| THOMAS M. BARTZ3 Filed as: THOMAS M BARTZ | 250 N. PATRICK BLVD SUITE 100 BROOKFIELD, WI 53045 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $21K | — | $21K | 0.76% |
| BENECO3 Filed as: BENECO OF WISCONSIN | 250 N. PATRICK ROAD SUITE 100 BROOKFIELD, WI 53045 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $5K | — | $5K | 0.19% |
| BENEFITS INC3 | 250 N. PATRICK BLVD STE 100 BROOKFIELD, WI 53045 | ANTHEM LIFE INSURANCE | $9K | — | $9K | 12.16% |
| BARBARA MOMBERG3 | 101 GRAND AVENUE SUITE 11 PORT WASHINGTON, WI 53074 | ANTHEM LIFE INSURANCE | $457 | — | $457 | 0.61% |
| BENEFITS INC3 Filed as: BENEFITS INC. | 250 N. PATRICK BLVD STE 100 BROOKFIELD, WI 53045 | WYSSTA INSURANCE COMPANY | $2K | — | $2K | 6.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT ADVANTAGE EIN 39-2023593 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $11K |
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 | 214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 202 | $2.7M |
| Dental | DELTA DENTAL OF WISCONSIN | 214 | $49K |
| Vision | WYSSTA INSURANCE COMPANY | 202 | $35K |
| Life insurance | ANTHEM LIFE INSURANCE | 212 | $74K |
| Short-term disability | ANTHEM LIFE INSURANCE | 212 | $74K |
| Long-term disability | ANTHEM LIFE INSURANCE | 212 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.