| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 245 S EXECUTIVE DR. SUITE 200 BROOKFIELD, WI 53005 | DELTA DENTAL OF WISCONSIN | $14K | — | $14K | 1.26% |
| DBA INSURANCE POINT AGENCY LLC3 | 181 E 5600 S STE 240 SALT LAKE CITY, UT 84107 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $27K | $27K | 16.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF WISCO EIN 39-0138065 NONE | Float revenue; 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 | — | $454K |
| GALLAGHER BENEFIT SERVICES, INC. EIN 36-4291971 NONE | Consulting (general) Service code 16 | — | $268K |
| MEDCO HEALTH SOLUTIONS, INC. EIN 22-3461740 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $220K |
| WELS EIN 39-0842084 PLAN SPONSOR | Other fees Service code 99 | — | $219K |
| VON BRIESEN & ROPER EIN 39-1576289 LEGAL | Legal Service code 29 | — | $52K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing Service code 12 | — | $39K |
| MILLIMAN EIN 91-0675641 NONE | Actuarial Service code 11 | — | $32K |
| MARQUETTE ASSOCIATES EIN 36-3485298 NONE | Investment advisory (plan) Service code 27 | — | $26K |
| WELLS FARGO BANK, NA EIN 94-1347393 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $22K |
| GRUPPO MARCUCCI, LLC EIN 27-2955023 NONE | Consulting (general) Service code 16 | — | $20K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 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 | — | $18K |
| HERITAGE PRINTING EIN 39-1174024 NONE | Other services Service code 49 | — | $7K |
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 | 3,401 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 84 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,485 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 1,322 | $1.1M |
| Vision | VISION SERVICE PLAN | 3,535 | $515K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,767 | $274K |
| Long-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,794 | $406K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF WISCONSIN | 3,489 | $222K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,794 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.