| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DR STE 400 BLOOMINGTON, MN 554371184 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | $900 | $10K | 11.08% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DR KIMBERLY, WI 541360000 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 6.36% |
| AUXIANT3 | 1233N MAYFAIR ROAD SUITE 207 WAUWATOSA, WI 53226 | HCC LIFE INSURANCE COMPANY | $3K | $675 | $3K | 12.70% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23446 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $63 | $2K | 15.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED STATES FIRE EIN 13-5459190 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $63K |
| USI INSURANCE SERVICES BROKER | Other commissions Service code 55 | 100 N CORPORATE DRIVE STE 100 BROOKFIELD, WI 53045 | $37K |
| AUXIANT BROKER | Other commissions Service code 55 | 2450 RIMROCK RD MADISON, WI 53713 | $18K |
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 | 170 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 135 | $78K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 263 | $15K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 193 | $92K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 193 | $92K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 193 | $92K |
| Other | HCC LIFE INSURANCE COMPANY | 131 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 263 | — |
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.