| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 400 N EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 53005 | BLUE CARE NETWORK OF MICHIGAN | $6K | — | $6K | 2.48% |
| DAVID J RADKE3 Filed as: DAVID RADKE | PO BOX 1650 MILWAUKEE, WI 53201 | BLUE CARE NETWORK OF MICHIGAN | $2K | — | $2K | 0.97% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 93033 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 5.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | — | $4K | $4K | 3.31% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: EMPLOYEE BENEFIT RISK MANAGEMENT | 823 COMMERCE DR. #350 OAK BROOK, IL 60523 | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | $728 | — | $728 | 0.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 330 WEST COLLEGE AVENUE UNIT 201 APPLETON, WI 54911 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $612 | — | $612 | 4.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 111 E KILBOURN AVE SUITE 1850 MILWAUKEE, WI 53202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $434 | — | $434 | 9.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET ST SUITE 3400 SAN FRANCISCO, CA 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $119 | $119 | 2.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 122 EAST COLLEGE AVENUE SUITE 201 APPLETON, WI 54911 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $566 | — | $566 | 12.34% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHED* | 600 COLLEGE AVE PEWAUKEE, WI 53072 | NORTHWESTERN MUTUAL | $455 | $110 | $565 | 20.21% |
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 | 375 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 377 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 18 | $373K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 375 | $128K |
| Short-term disability(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 17 | $12K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 375 | $124K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 18 | $373K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 375 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 375 | — |
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."
No prospect flags tripped on this filing.