| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 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 | $66K | — | $66K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | 525 MARKET ST, SUITE 3400 SAN FRANCISCO, CA 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | $40K | — | $40K | 6.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 400 N EXECUTIVE DR, STE 300 BROOKFIELD, WI 530056005 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 400 N EXECUTIVE DR, STE 300 BROOKFIELD, WI 530056005 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.20% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE, SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $157 | $157 | 0.09% |
| 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 | $5K | — | $5K | 10.66% |
| PETER H HOOPIS3 Filed as: PETER HOOPIS | 300 S WACKER DR STE 2000 CHICAGO, IL 606066736 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $1K | $715 | $2K | 3.67% |
| 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 | 5.94% |
| 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 | $2K | — | $2K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $333K |
| 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 | 758 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 758 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 390 | $0 |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 758 | $42K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 406 | $170K |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 406 | $220K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 347 | $659K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 406 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 758 | — |
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.