| 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 | 5.00% |
| LOCKTON COMPANIES, LLC3 | 525 WEST MONROE STREET, SUITE 600 CHICAGO, IL 60661 | RELIASTAR LIFE INSURANCE COMPANY | $23K | $7K | $30K | 6.11% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY, INC. | 3100 EAST MIRALOMA AVENUE SUITE 240 ANAHEIM, CA 92806 | RELIASTAR LIFE INSURANCE COMPANY | $10K | $2K | $12K | 2.47% |
| BENEFIT EDUCATORS LLC3 Filed as: BENEFIT EDUCATORS, LLC | 2516 WAUKEGAN ROAD, SUITE 357 GLENVIEW, IL 60025 | RELIASTAR LIFE INSURANCE COMPANY | $918 | $0 | $918 | 0.19% |
| LOCKTON COMPANIES, LLC3 | 111 EAST KILBOURN AVENUE, SUITE 825 MILWAUKEE, WI 53202 | HARTFORD FIRE INSURANCE COMPANY | $0 | $66 | $66 | 2.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $3.8M |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $239K |
| USBANK EIN 31-0841368 TRUSTEE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $24K |
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 | 642 | 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) | 642 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,165 | $74K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 1,008 | $485K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 1,008 | $485K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 461 | $830K |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,008 | $502K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,165 | — |
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.