| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 93033 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $2K | $10K | 7.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 122 EAST COLLEGE AVE SUITE 201 APPLETON, WI 54911 | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | $5K | — | $5K | 3.71% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: EMPLOYEE BENEFIT RISK MANAGEMENT | 823 COMMERCE DR. ATE 350 OAKBROOK, IL 60523 | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | — | $833 | $833 | 0.66% |
| TRACY GAHLMAN3 | WILLIS OF WISCONSIN, INC 2323 N MAYFAIR RD, STE 600 MILWAUKEE, WI 53226 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $4K | — | $4K | 4.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | SUN LIFE ASSURANCE COMPANY OF CANADA | $730 | — | $730 | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE OF CA INC | PO BOX 101162 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $107 | $107 | 1.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC | 122 E COLLEGE AVE STE 201 APPLETON, WI 54911 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $724 | $76 | $800 | 13.05% |
| WILLIAM F CLANCY3 | 108 PALAFOX PL PENSACOLA, FL 32502 | NORTHWESTERN MUTUAL | $253 | $64 | $317 | 8.06% |
| WILLIAM JOHN COLLINS3 | 100 E WISCONSIN AVE STE 2300 MILWAUKEE, WI 53202 | NORTHWESTERN MUTUAL | $126 | $35 | $161 | 4.10% |
| BRIAN P DIX3 | 100 E WISCONSIN AVE STE 2300 MILWAUKEE, WI 53202 | NORTHWESTERN MUTUAL | $76 | $21 | $97 | 2.47% |
| R SCOTT SCHWERTFEGER3 | 500 W SILVER SPRING DR STE K-290 GLENDALE, WI 53217 | NORTHWESTERN MUTUAL | $51 | $13 | $64 | 1.63% |
| KOCH INSURANCE INC3 Filed as: KOCH FNCL GRP LLC | 245 RIVERSIDE AVE STE 100 JACKSONVILLE, FL 32202 | NORTHWESTERN MUTUAL | $52 | $6 | $58 | 1.48% |
| THE HOLTER AGENCY INC3 | 100 E WISCONSIN AVE STE 2300 MILWAUKEE, WI 53202 | NORTHWESTERN MUTUAL | $47 | $6 | $53 | 1.35% |
| CHRISTOPHER DAVID CARLSON3 | 500 W SILVER SPRING DR STE K-290 GLENDALE, WI 53217 | NORTHWESTERN MUTUAL | $6 | $2 | $8 | 0.20% |
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 | 494 | 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) | 499 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 35 | $533K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 494 | $138K |
| Short-term disability(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 30 | $17K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 494 | $132K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 35 | $331K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 494 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 494 | — |
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.