| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WI, INC. | 400 N EXECUTIVE DR, STE 300 BROOKFIELD, WI 53005 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | PO BOX 101162 PASADENA, CA 911890001 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 0.75% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE, STE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $143 | $143 | 0.04% |
| 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 | — | $6K | 14.46% |
| PETER H HOOPIS3 Filed as: PETER HOOPIS | 300 S WACKER DR STE 2000 CHICAGO, IL 606066736 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 2.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | 400 N EXECUTIVE DR, STE 300 BROOKFIELD, WI 53005 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 6.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WI, INC. | 400 N EXECUTIVE DR, STE 300 BROOKFIELD, WI 53005 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 5.00% |
| 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 | — | $440K |
| 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 | 799 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 799 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 397 | $0 |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 0 | $44K |
| Life insurance(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 432 | $360K |
| Long-term disability(3 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 432 | $405K |
| Other(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 432 | $360K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 432 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.