| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $404 | $404 | 0.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 93033 NETWORK PLACE CHICAGO, IL 60673 | METROPOLITAN LIFE INSURANCE COMPANY | $51K | $78 | $51K | 14.28% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF MASSACHUSETTS | 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | METROPOLITAN LIFE INSURANCE COMPANY | $18K | $1K | $19K | 5.29% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 775 YARD STREET, SUITE 200 COLUMBUS, OH 43212 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $5K | $5K | 1.45% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 SOUTH GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.35% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF MASSACHUSETTS | PO BOX 745957 ATLANTA, GA 30374 | METROPOLITAN GENERAL INSURANCE COMPANY | $4K | $0 | $4K | 8.53% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 400 NORTH EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 53005 | METROPOLITAN GENERAL INSURANCE COMPANY | $733 | $0 | $733 | 1.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 400 NORTH EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 53005 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
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 | 2,244 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 41 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 1,637 | $1.1M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 2,803 | $228K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,082 | $767K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,082 | $767K |
| Other(5 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,244 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,803 | — |
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.