| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | 353 N. CLARK STREET CHICAGO, IL 60654 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $20K | — | $20K | 3.20% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $10K | — | $10K | 1.68% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 3.15% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES INC. | 353 N. CLARK ST., STE.1100 CHICAGO, IL 60654 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $4K | $9K | 7.84% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 2.42% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | DELTA DENTAL OF WISCONSIN | $2K | — | $2K | 3.23% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES INC. | 353 N CLARK ST., STE. 1100 CHICAGO, IL 60654 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $2K | $5K | 9.80% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.46% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES INC. | 353 N. CLARKE ST., STE. 1100 CHICAGO, IL 60173 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $2K | $5K | 9.78% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.45% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK ST., STE 1100 CHICAGO, IL 60654 | LINCOLN NATIONAL LIFE INSURANCE CO | $2K | $1K | $4K | 9.29% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK ST., STE 1100 CHICAGO, IL 60654 | LINCOLN NATIONAL LIFE INSURANCE CO | $2K | $1K | $4K | 9.29% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | LINCOLN NATIONAL LIFE INSURANCE CO | $1K | $1K | $3K | 6.51% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | LINCOLN NATIONAL LIFE INSURANCE CO | $1K | — | $1K | 3.61% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | UNITEDHEALTHCARE INSURANCE COMPANY | $876 | — | $876 | 2.55% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | UNITEDHEALTHCARE INSURANCE COMPANY | $876 | — | $876 | 2.55% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES INC. | 353 NORTH CLARK ST. CHICAGO, IL 60654 | WYSSTA INSURANCE COMPANY INC. | $3K | — | $3K | 8.45% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | WYSSTA INSURANCE COMPANY INC. | $1 | — | $1 | 0.00% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES INC. | 353 N. CLARK ST., STE. 1100 CHICAGO, IL 60654 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $507 | $205 | $712 | 9.06% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $278 | — | $278 | 3.54% |
No Schedule C service providers reported on this filing.
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 | 397 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 402 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 759 | $614K |
| Dental(2 contracts) | DELTA DENTAL OF WISCONSIN | 174 | $227K |
| Vision | WYSSTA INSURANCE COMPANY INC. | 267 | $34K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 397 | $56K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 397 | $109K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 397 | $53K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF WISCONSIN | 759 | $614K |
| Other(4 contracts, 3 carriers) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 397 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 759 | — |
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.