| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 123042 DALLAS, TX 753123042 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $96K | $15K | $111K | 8.10% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 123042 DALLAS, TX 753123042 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $62K | $26K | $88K | 9.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | CARE-PLUS DENTAL PLANS, INC. | $9K | — | $9K | 8.00% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | EXPRESS SCRIPTS, INC. PRESCRIPTION DRUG PLAN | $6K | — | $6K | 7.69% |
| HUB INTERNATIONAL MIDWEST LIMITED5 | 55 E JACKSON BLVD CHICAGO, IL 60604 | EXPRESS SCRIPTS, INC. PRESCRIPTION DRUG PLAN | $3K | — | $3K | 3.59% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGTOWN, RI 02852 | TRANSAMERICA INSURANCE CO. MEDICARE SUPPLEMENT | $7K | — | $7K | 14.19% |
| HUB INTERNATIONAL MIDWEST LIMITED5 | 55 E JACKSON BLVD CHICAGO, IL 60604 | TRANSAMERICA INSURANCE CO. MEDICARE SUPPLEMENT | $2K | — | $2K | 3.70% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 123042 DALLAS, TX 753123042 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $2K | $5K | 10.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPATHIA, INC. EIN 39-1567366 EAP PROVIDER | Other services Service code 49 | N17W24100 RIVERWOOD DRIVE, STE 300 WAUKESHA, WI 53188 | $156K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMIN | Contract Administrator Service code 13 | — | $108K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTONA AVE HARTFORD, CT 06156 | $87K |
| HUB INTERNATIONAL BROKER | Insurance agents and brokers Service code 22 | ATTN ROBERTY BRYAN 55 EAST JACKSON BLVD #14A CHICAGO, IL 606044187 | $2K |
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 | 3,923 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,944 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRANSAMERICA INSURANCE CO. MEDICARE SUPPLEMENT | 39 | $51K |
| Dental | CARE-PLUS DENTAL PLANS, INC. | 426 | $107K |
| Vision | VISION SERVICE PLAN | 2,774 | $568K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 3,923 | $885K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 3,913 | $1.4M |
| Prescription drug | EXPRESS SCRIPTS, INC. PRESCRIPTION DRUG PLAN | 35 | $72K |
| Other(3 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 3,923 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,923 | — |
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.