| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 400 N. EXECUTIVE DR. STE. 300 BROOKFIELD, WI 53005 | DELTA DENTAL OF WISCONSIN | $7K | — | $7K | 0.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 0.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF WISCO EIN 39-0138065 NONE | Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $2.2M |
| BSWIFT, LLC EIN 36-4391310 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $488K |
| WELS EIN 39-0842084 PLAN SPONSOR | Other fees Service code 99 | — | $275K |
| MEDCO HEALTH SOLUTIONS, INC. EIN 22-3461740 NONE | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $259K |
| MILLIMAN EIN 91-0675641 NONE | Actuarial Service code 11 | — | $121K |
| WILLIS TOWERS WATSON EIN 53-0181291 NONE | Consulting (general); Actuarial Service code 11 | — | $107K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Other services; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $47K |
| MARQUETTE ASSOCIATES EIN 36-3485298 NONE | Investment advisory (plan) Service code 27 | — | $29K |
| MICHAEL BEST & FRIEDRICH EIN 39-0934985 NONE | Legal Service code 29 | — | $20K |
| BAKER TILLY US, LLP EIN 30-1413443 NONE | Accounting (including auditing) Service code 10 | — | $19K |
| BMO HARRIS BANK NA EIN 36-2085229 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $13K |
| WELLS FARGO BANK, NA EIN 94-1347393 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $12K |
| HERITAGE PRINTING EIN 39-1174024 NONE | Other services Service code 49 | — | $12K |
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 | 3,640 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 59 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,699 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 2,009 | $2.2M |
| Vision | VISION SERVICE PLAN | 3,693 | $603K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,922 | $1.1M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,922 | $1.1M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF WISCONSIN | 3,662 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,922 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.