| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 10 SOUTH LASALLE STREET STE. 3000 CHICAGO, IL 60603 | MINNESOTA LIFE INSURANCE COMPANY | $53K | — | $53K | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | PO BOX 101162 PASADENA, CA 91189 | MINNESOTA LIFE INSURANCE COMPANY | — | $30K | $30K | 2.27% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 400 N EXECUTIVE DR. STE 300 BROOKFIELD, WI 53005 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $34K | $0 | $34K | 3.27% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 223 S WACKER DR STE. 1800 CHICAGO, IL 60606 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $18K | $18K | 1.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93033 NETWORK PL CHICAGO, IL 60673 | VISION SERVICE PLAN | $29K | — | $29K | 4.97% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 10 SOUTH LASALLE STREET STE. 3000 CHICAGO, IL 60603 | MINNESOTA LIFE INSURANCE COMPANY | $14K | — | $14K | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | PO BOX 101162 PASADENA, CA 91189 | MINNESOTA LIFE INSURANCE COMPANY | — | $8K | $8K | 2.27% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 10 SOUTH LASALLE STREET STE. 3000 CHICAGO, IL 60603 | MINNESOTA LIFE INSURANCE COMPANY | $7K | — | $7K | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | PO BOX 101162 PASADENA, CA 91189 | MINNESOTA LIFE INSURANCE COMPANY | — | $4K | $4K | 2.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS & BLUE SHIELD OF WISCONS EIN 39-0138065 CLAIMS ADMINISTRATION | Float revenue; Other services; Insurance agents and brokers; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other commissions; Claims processing; Insurance brokerage commissions and fees Service code 12 | — | $1.3M |
| BUSINESSOLVER EIN 42-1503807 BENEFITS ADMINISTRATION | Other services Service code 49 | — | $245K |
| WILLIS TOWERS WATSON US LLC EIN 53-0181291 ACTUARIAL | Actuarial Service code 11 | — | $177K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 CLAIMS ADMINISTRATION | Contract Administrator; Insurance agents and brokers Service code 13 | — | $79K |
| COLEMAN & WILLIAMS, LTD EIN 39-1658905 AUDIT | Accounting (including auditing) Service code 10 | — | $40K |
| CONNECTYOURCARE, LLC (CYC) EIN 26-1274092 CLAIMS ADMINISTRATION | Contract Administrator; Other fees; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $26K |
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 | 3,085 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,085 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 3,162 | $583K |
| Life insurance(3 contracts) | MINNESOTA LIFE INSURANCE COMPANY | 4,018 | $1.9M |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 930 | $1.0M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF WISCONSIN | 3,136 | $1.3M |
| Other | NATIONAL UNION FIRE INS. | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,018 | — |
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.