| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC Filed as: ACRISURE | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | CONTINENTAL AMERICAN INSURANCE COMPANY | — | $134K | $134K | 54.34% |
| DIRECTPATH, LLC3 Filed as: DIRECTPATH LLC | 120 18TH ST STE 102 BIRMINGHAM, AL 35233 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 16.51% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES LLC | PO BOX 510187 NEW BERLIN, WI 53151 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $350 | $0 | $350 | 4.09% |
| ACRISURE LLC3 | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1 | $125 | $126 | 1.47% |
| DIRECTPATH, LLC3 Filed as: DIRECTPATH LLC | 120 18TH ST STE 102 BIRMINGHAM, AL 35233 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 21.17% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES LLC | PO BOX 510187 NEW BERLIN, WI 53151 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $320 | — | $320 | 3.86% |
| ACRISURE LLC3 | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $118 | $123 | $241 | 2.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF WISCONSIN EIN 39-0138065 HEALTH PPO | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator; Claims processing Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $472K |
| PREFERRED HEALTH CHOICES EIN 90-0139311 CLAIMS PROCESSING | Claims processing Service code 12 | PO BOX 5003 DUBUQUE, WI 52002 | $277K |
| AMERIBEN / IEC GROUP EIN 82-0497661 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | P.O. BOX 7186 BOISE, ID 83707 | $168K |
| NAVITUS HEALTH SOLUTIONS EIN 04-3608530 CLAIMS PROCESSING (PBM) | Claims processing Service code 12 | 1025 WEST NAVITUS DRIVE APPLETON, WI 54913 | $76K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 TPA (DENTAL BENEFIT) | Contract Administrator Service code 13 | PO BOX 828 STEVENS POINT, WI 54481 | $64K |
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 | 1,685 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,696 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,398 | $114K |
| Life insurance | CIGNA GROUP INSURANCE | 1,638 | $73K |
| Long-term disability | CIGNA GROUP INSURANCE | 1,638 | $159K |
| Stop-loss / reinsurancereinsurance(2 contracts) | HCC LIFE INSURANCE COMPANY | 1,392 | $814K |
| Other(4 contracts, 3 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 828 | $263K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,638 | — |
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."
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.