| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 93033 NETWORK PL CHICAGO, IL 606731970 | VISION SERVICE PLAN | — | $28K | $28K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | PO BOX 101162 PASADENA, CA 91189 | MINNESOTA LIFE INSURANCE COMPANY | $18K | — | $18K | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 10 SOUTH LASALLE STREET STE. 3000 CHICAGO, IL 606031002 | MINNESOTA LIFE INSURANCE COMPANY | — | $10K | $10K | 2.26% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | PO BOX 101162 PASADENA, CA 91189 | MINNESOTA LIFE INSURANCE COMPANY | $514 | — | $514 | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 10 SOUTH LASALLE STREET STE. 3000 CHICAGO, IL 606031002 | MINNESOTA LIFE INSURANCE COMPANY | — | $290 | $290 | 2.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS BLUE SHIELD EIN 39-0138065 CLAIMS ADMINISTRATION | Other commissions; Float revenue; Insurance agents and brokers; Other services; Claims processing; Insurance brokerage commissions and fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.1M |
| ALIGHT SOLUTIONS EIN 22-2232264 BENEFITS MANAGER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services Service code 13 | — | $184K |
| BUSINESSOLVER EIN 42-1503807 ADMIN | Plan Administrator Service code 14 | — | $102K |
| WILLIS TOWERS WATSON VIA BENEFITS EIN 26-0775680 CLAIMS ADMINISTRATION | Claims processing; Contract Administrator Service code 12 | — | $92K |
| PARAMETRIC DEFENSIVE EQUITY FUND EIN 45-2531297 INVESTMENT MANAGER | Investment management Service code 28 | — | $62K |
| NAVITUS HEALTH SOLUTIONS EIN 04-3608530 CLAIMS ADMINISTRATION | Claims processing; Contract Administrator Service code 12 | — | $53K |
| DELTA DENTAL EIN 39-6094742 CLAIMS ADMINISTRATION | Contract Administrator; Insurance agents and brokers Service code 13 | — | $42K |
| NEPC EIN 26-1429809 CONSULTANT | Consulting (general) Service code 16 | — | $31K |
| CONNECTYOURCARE, LLC (CYC) EIN 26-1274092 CLAIMS ADMINISTRATION | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Claims processing; Contract Administrator Service code 12 | — | $27K |
| COLEMAN & WILLIAMS, LTD. EIN 39-1658905 AUDIT | Accounting (including auditing) Service code 10 | 7127 N. GREEN BAY AVE. MILWAUKEE, WI 53209 | $27K |
| PRINCIPAL CUSTODY SOLUTIONS EIN 51-0099493 TRUSTEE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $13K |
| AON INVESTMENTS EIN 36-3109431 INVESTMENT MANAGER | Investment management Service code 28 | — | $7K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3,448 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,448 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 3,028 | $556K |
| Life insurance(2 contracts) | MINNESOTA LIFE INSURANCE COMPANY | 989 | $452K |
| Prescription drug | NAVITUS HEALTH SOLUTIONS | 7,870 | $466K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF WISCONSIN | 3,128 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,870 | — |
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.