| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HCC LIFE INSURANCE COMPANY | $0 | $41K | $41K | 4.99% |
| LOCKTON COMPANIES, LLC3 | 525 WEST MONROE STREET, SUITE 600 CHICAGO, IL 60661 | RELIASTAR LIFE INSURANCE COMPANY | $30K | $8K | $38K | 6.77% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON SPECIALTIES, LLC | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $14K | $14K | 2.53% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY, INC. | 3100 EAST MIRALOMA AVENUE SUITE 240 ANAHEIM, CA 92806 | RELIASTAR LIFE INSURANCE COMPANY | $9K | $3K | $12K | 2.12% |
| BENEFIT EDUCATORS LLC3 Filed as: BENEFIT EDUCATORS, LLC | 2516 WAUKEGAN ROAD, SUITE 357 GLENVIEW, IL 60025 | RELIASTAR LIFE INSURANCE COMPANY | $884 | $0 | $884 | 0.16% |
| LOCKTON COMPANIES, LLC3 | 111 EAST KILBOURN AVENUE, SUITE 825 MILWAUKEE, WI 53202 | HARTFORD FIRE INSURANCE COMPANY | $0 | $44 | $44 | 1.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $305K |
| US BANK EIN 31-0841368 TRUSTEE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $20K |
| DELTA DENTAL OF WISCONSIN EIN 36-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $20K |
| COLEMAN & WILLIAMS LTD EIN 39-1658905 AUDITOR | Accounting (including auditing) Service code 10 | — | $18K |
| BAKER TILLY EIN 39-0859910 AUDITOR | Accounting (including auditing) Service code 10 | — | $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 | 687 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 687 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,220 | $78K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 823 | $556K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 823 | $556K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 485 | $830K |
| Other(4 contracts, 4 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 823 | $592K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,220 | — |
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.