| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC5 Filed as: WILLIS OF WI, INC. | 2323 N MAYFAIR RD STE 600 MILWAUKEE, WI 53226 | SYMETRA LIFE INSURANCE COMPANY | $73K | $19K | $92K | 16.77% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WI, INC. | 400 N EXECUTIVE DR, STE 300 BROOKFIELD, WI 53005 | SYMETRA LIFE INSURANCE COMPANY | $15K | — | $15K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WI, INC. | 122 E COLLEGE AVE STE 201 APPLETON, WI 549115794 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $6K | $243 | $7K | 14.51% |
| PETER H HOOPIS3 Filed as: PETER HOOPIS | 300 S WACKER DR STE 2000 CHICAGO, IL 606066736 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $0 | $263 | $263 | 0.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | 400 N EXECUTIVE DR, STE 300 BROOKFIELD, WI 53005 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 5.51% |
| DELTA DENTAL OF WISCONSIN5 | PO BOX 828 STEVENS POINT, WI 544810828 | DELTA DENTAL OF WISCONSIN | $19K | — | $19K | — |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WI, INC. | 400 N EXECUTIVE DR, STE 300 BROOKFIELD, WI 53005 | DELTA DENTAL OF WISCONSIN | $3K | — | $3K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $378K |
| WILLIS OF WISCONSIN, INC. EIN 39-0765647 BROKER | Other commissions Service code 55 | 400 N. EXECUTIVE DRIVE, SUITE 300 BROOKFIELD, WI 53005 | $0 |
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 | 775 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 775 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 419 | $0 |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 775 | $45K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 374 | $154K |
| Long-term disability(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 374 | $199K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 728 | $548K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 374 | $154K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 775 | — |
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.