| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPITOL SPECIAL RISKS3 | 1000 PARKWOOD CIR #925 ATLANTA, GA 30339 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 11.25% |
| JOHN L TODD3 | 729 RAGSDALE RD SHARPSBURG, GA 30277 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT PLAN ADMINISTRATION OF WI, EIN 39-1400101 NONE | Plan Administrator; Claims processing; Direct payment from the plan; Other services Service code 12 | — | $1.0M |
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $856K |
| UMR NONE | Other services; Direct payment from the plan Service code 49 | P.O. BOX 88822 MILWAUKEE, WI 532880822 | $157K |
| REINHART BOERNER VAN DEUREN S.C. EIN 39-1126909 NONE | Legal; Direct payment from the plan Service code 29 | — | $144K |
| ENVISION RX EIN 90-1011712 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $90K |
| ASSOCIATED TRUST COMPANY, N.A. EIN 39-6576073 NONE | Other services; Direct payment from the plan; Investment management fees paid directly by plan; Investment management Service code 28 | — | $63K |
| LEE JOST & ASSOCIATES EIN 39-1400101 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $51K |
| NETWORK HEALTH SYSTEMS, INC. EIN 39-1127163 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $38K |
| FREYBERG HINKLE ET AL EIN 39-1531945 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $19K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $19K |
| CITYPRESS INC. NONE | Copying and duplicating; Direct payment from the plan Service code 36 | W238 N1650 ROCKWOOD DRIVE WAUKESHA, WI 53188 | $18K |
| ANDCO CONSULTING LLC EIN 59-3676225 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $15K |
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 | 1,659 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 389 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,048 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,923 | $40K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,731 | $453K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,923 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,923 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.