| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | SYMETRA LIFE INSURANCE COMPANY | $31K | — | $31K | 10.00% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GROUP, LLC | 711 EISENHOWER DR. KIMBERLY, WI 541362142 | RELIASTAR LIFE INSURANCE COMPANY | $4K | $3K | $8K | 8.93% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MANAGMNT | Float revenue; Claims processing; Other fees; Direct payment from the plan Service code 12 | — | $1.0M |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $167K |
| BMO RETIREMENT SERVICES EIN 36-2085229 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 221 W. COLLEGE AVENUE APPLETON, WI 54912 | $25K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 INSURANCE AGENT OR BROKER | Insurance agents and brokers; Contract Administrator Service code 13 | 2801 HOOVER ROAD PO BOX 828 STEVENS POINT, WI 54481 | $21K |
| ASSOCIATED FINANCIAL GROUP LLC EIN 91-2189930 BROKER | Other commissions Service code 55 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | $14K |
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 | 464 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 464 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 335 | $87K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 464 | $313K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 464 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.