| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERV NATIONAL INC | PO BOX 201503 DALLAS, TX 753201503 | MINNESOTA LIFE INSURANCE COMPANY | $47K | — | $47K | 2.68% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | MINNESOTA LIFE INSURANCE COMPANY | $23K | — | $23K | 1.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO | 150 N. MICHIGAN AVE. CHICAGO, IL 60601 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $20K | — | $20K | 2.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO | PO BOX 203066 DALLAS, TX 753203066 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $16K | $16K | 1.78% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $7K | — | $7K | 0.74% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERV NATIONAL INC | PO BOX 201503 DALLAS, TX 753201503 | MINNESOTA LIFE INSURANCE COMPANY | $9K | — | $9K | 2.67% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | MINNESOTA LIFE INSURANCE COMPANY | $5K | — | $5K | 1.33% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERV NATIONAL INC | PO BOX 201503, GEORGIA LOCKBOX DALLAS, TX 753201503 | MINNESOTA LIFE INSURANCE COMPANY | $5K | — | $5K | 2.69% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | MINNESOTA LIFE INSURANCE COMPANY | $2K | — | $2K | 1.31% |
| REUBEN WARNER ASSOCIATES, INC. Filed as: REUBEN WARNER ASSOCIATES | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 25.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS BLUE SHIELD EIN 39-0138065 CLAIMS ADMINISTRATION | Float revenue; Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $2.0M |
| ALIGHT SOLUTIONS EIN 22-2232264 BENEFITS MANAGER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services Service code 13 | — | $317K |
| NAVITUS HEALTH SOLUTIONS EIN 04-3608530 CLAIMS ADMINISTRATION | Contract Administrator; Claims processing Service code 12 | — | $199K |
| WILLIS TOWERS WATSON INC. EIN 53-0181291 ACTUARIAL | Actuarial Service code 11 | — | $173K |
| ALIGHT SOLUTIONS (YSA) EIN 22-2232264 CLAIMS ADMINISTRATION | Contract Administrator; Claims processing Service code 12 | — | $168K |
| DELTA DENTAL EIN 39-6094742 CLAIMS ADMINISTRATION | Contract Administrator; Claims processing Service code 12 | — | $133K |
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 | 3,254 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 27 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 0 | $0 |
| Vision | BLUE CROSS BLUE SHIELD OF WISCONSIN | 0 | $0 |
| Life insurance(3 contracts) | MINNESOTA LIFE INSURANCE COMPANY | 4,756 | $2.3M |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 4,213 | $886K |
| Prescription drug | NAVITUS HEALTH SOLUTIONS | 10,515 | $0 |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,515 | — |
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."
No prospect flags tripped on this filing.