| 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 | $46K | $46K | 5.00% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY, INC. | 1820 EAST FIRST STREET, SUITE 400 SANTA ANA, CA 92705 | RELIASTAR LIFE INSURANCE COMPANY | $13K | $2K | $15K | 3.16% |
| BENEFIT EDUCATORS LLC3 Filed as: BENEFIT EDUCATORS, LLC | 2516 WAUKEGAN ROAD, SUITE 357 GLENVIEW, IL 60025 | RELIASTAR LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.25% |
| LOCKTON COMPANIES, LLC3 | 111 EAST KILBOURN AVENUE, SUITE 825 MILWAUKEE, WI 53202 | HARTFORD FIRE INSURANCE COMPANY | $0 | $56 | $56 | 7.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $297K |
| USBANK EIN 31-0841368 TRUSTEE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $48K |
| BAKER TILLY EIN 39-0859910 AUDITOR | Accounting (including auditing) Service code 10 | — | $23K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $19K |
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 | 620 | 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) | 620 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,122 | $68K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 1,009 | $473K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 1,009 | $473K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 468 | $919K |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,009 | $489K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,122 | — |
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."
No prospect flags tripped on this filing.