| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 400 N EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 53005 | SUN LIFE ASSURANCE COMPANY OF CANADA | $359K | — | $359K | 4.83% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WTW INSURANCE SERVICES WEST INC | PO BOX 101162 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $71K | $71K | 0.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | 400 N EXECUTIVE DR SUITE 300 BROOKFIELD, WI 53005 | METLIFE LEGAL PLANS | $15K | — | $15K | 12.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | C/O JP MORGAN CHASE 93033 NETWORK PLACE CHICAGO, IL 60673 | METLIFE LEGAL PLANS | — | $436 | $436 | 0.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 400 NORTH EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | METLIFE LEGAL PLANS | — | $28 | $28 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF WI EIN 39-0138065 NONE | Claims processing; Contract Administrator; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $5.8M |
| ALIGHT SOLUTIONS LLC NONE | Contract Administrator; Direct payment from the plan Service code 13 | 10 NORTH PARK DRIVE SUITE 400 HUNT VALLEY, MD 21030 | $965K |
| LIMEADE EIN 06-1771116 NONE | Other services; Direct payment from the plan Service code 49 | — | $602K |
| CVS CAREMARK NONE | Other services; Direct payment from the plan Service code 49 | 1 CVS DRIVE WOONSOCKET, RI 02895 | $486K |
| LYRA NONE | Other services; Direct payment from the plan Service code 49 | 287 LORTON AVE, STE 2 BURLINGAME, CA 94010 | $406K |
| WILLIS TOWERS WATSON US LLC EIN 53-0181291 NONE | Consulting (general); Insurance agents and brokers; Actuarial; Direct payment from the plan Service code 11 | — | $388K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 NONE | Direct payment from the plan; Insurance agents and brokers; Contract Administrator Service code 13 | — | $312K |
| STATE STREET GLOBAL ADVISORS EIN 81-4017137 NONE | Custodial (other than securities); Investment management fees paid directly by plan; Custodial (securities) Service code 18 | — | $301K |
| SOLERA HEALTH INC EIN 47-5298764 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $211K |
| LIVONGO NONE | Direct payment from the plan; Other services Service code 49 | 444 N MICHIGAN AVE CHICAGO, IL 60611 | $199K |
| METLIFE EIN 34-1650967 NONE | Legal; Direct payment from the plan Service code 29 | — | $172K |
| UNITED HEALTHCARE NONE | Claims processing; Other services; Direct payment from the plan Service code 12 | 161 CANAL STREET STE 200 NEW YORK, NY 10013 | $161K |
| CNH AMERICA LLC EIN 39-1982756 PLAN SPONSOR | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $123K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $92K |
| REINHART, BOERNER, VANDEUREN S.C EIN 39-1126909 NONE | Legal; Direct payment from the plan Service code 29 | — | $87K |
| ERNST & YOUNG EIN 34-6565596 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $39K |
| ONE TOUCHPOINT NONE | Direct payment from the plan; Contract Administrator Service code 13 | 1225 WALNUT RIDGE DRIVE HARTLAND, WI 530298300 | $36K |
| HEALTH CARE POLICY ROUNDTABLE NONE | Other services; Direct payment from the plan Service code 49 | 470 JAMES STREET NEW HAVEN, CT 06513 | $30K |
| TOWERS WATSON INVESTMENT SVS INC EIN 52-1868818 NONE | Investment management fees paid directly by plan; Investment management; Direct payment from the plan Service code 28 | — | $25K |
| ADP, LLC NONE | Direct payment from the plan; Other services Service code 49 | 1851 N RESLER DRIVE MS-100 EL PASO, TX 79912 | $18K |
| WRITE ON TARGET, INC. EIN 31-1431575 NONE | Other services; Participant communication; Other fees Service code 38 | — | $13K |
| CNS OCCUPATIONAL MEDICINE NONE | Other services; Direct payment from the plan Service code 49 | 151 KOSER ROAD LITITZ, PA 17543 | $6K |
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 | 8,600 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7,787 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 16,387 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 13,271 | $7.4M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 13,271 | $7.4M |
| Other(4 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 13,271 | $8.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,271 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.