| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE | PO BOX 28852 NEW YORK, NY 10087 | UNITED HEALTHCARE INSURANCE COMPANY | $333K | — | $333K | 5.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 400 N EXECUTIVE DR SUITE 300 BROOKFIELD, WI 53005 | SUN LIFE ASSURANCE COMPANY OF CANADA | $361K | — | $361K | 6.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | PO BOX 101162 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $75K | $75K | 1.27% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 160 FEDERAL ST. BOSTON, MA 02110 | SUN LIFE ASSURANCE COMPANY OF CANADA | -$10K | — | -$10K | -0.18% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL ST 2ND FLOOR BOSTON, MA 02110 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 0.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN | SUITE 300 400 N EXECUTIVE DR BROOKFIELD, WI 530056005 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $65 | — | $65 | 0.00% |
| CHUBB & SON3 | 330 E KILBOURN #450 MILWAUKEE, WI 53202 | FEDERAL INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| CHUBB & SON3 | 330 E KILBOURN #450 MILWAUKEE, WI 53202 | FEDERAL INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF WI EIN 39-0138065 NONE | Other services; Float revenue; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $6.4M |
| LIMEADE EIN 06-1771116 NONE | Other services; Direct payment from the plan Service code 49 | — | $797K |
| TOWERS WATSON DELAWARE INC. EIN 53-0181291 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $437K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $363K |
| STATE STREET BANK & TRUST EIN 04-1867445 NONE | Trustee (directed); Direct payment from the plan Service code 25 | — | $291K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $212K |
| SILVERSCRIPT INSURANCE COMPANY NONE | Other services; Direct payment from the plan Service code 49 | PO BOX 30001 PITTSBURGH, PA 15222 | $162K |
| CVS HEALTH NONE | Other services; Direct payment from the plan Service code 49 | ONE CVS DRIVE WOONSOCKET, RI 02895 | $152K |
| CAREOPERATIVE, LLC EIN 46-4399706 NONE | Other services; Direct payment from the plan Service code 49 | — | $137K |
| HYATT LEGAL PLANS EIN 34-1650967 NONE | Legal; Direct payment from the plan Service code 29 | — | $119K |
| CNH AMERICA LLC EIN 39-1982756 PLAN SPONSOR | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $116K |
| ADP, LLC NONE | Other services; Direct payment from the plan Service code 49 | 1851 N RESLER DRIVE MS-100 EL PASO, TX 79912 | $112K |
| REINHART, BOERNER, VANDEUREN S.C EIN 39-1126909 NONE | Legal; Direct payment from the plan Service code 29 | — | $101K |
| ONE TOUCH POINT EIN 39-1419951 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $101K |
| IBM EIN 13-0871985 NONE | Other services; Direct payment from the plan Service code 49 | — | $52K |
| TRUVEN HEALTH ANALYTICS EIN 06-1467923 NONE | Direct payment from the plan; Other services Service code 49 | — | $52K |
| ERNST & YOUNG EIN 34-6565596 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $37K |
| OMADA HEALTH INC. NONE | Direct payment from the plan; Other services Service code 49 | 500 SANSOME ST SAN FRANCISCO, CA 94111 | $32K |
| TOWERS WATSON INVESTMENT SVC INC EIN 52-1868818 NONE | Investment management fees paid directly by plan; Direct payment from the plan; Investment management Service code 28 | — | $25K |
| EQUITY CREATIVE NONE | Other services; Direct payment from the plan Service code 49 | 9522 58TH PLACE, SUITE 800 KENOSHA, WI 53144 | $14K |
| ZMAGS EIN 74-3261801 NONE | Other services; Direct payment from the plan Service code 49 | — | $5K |
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 | 7,892 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8,101 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 15,993 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 4,841 | $6.1M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 13,744 | $5.9M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,898 | $1.9M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,898 | $1.9M |
| Other(2 contracts) | FEDERAL INSURANCE COMPANY | 7,892 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,744 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.