| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| H.J. KNIGHT INTERNATIONAL INSURANCE3 | 30 BRAINTREE HILL OFFICE PARK, STE BRAINTREE, MA 02184 | HCC LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| TRICOR, INC3 Filed as: TRICOR, INC. | 230 W CHERRY STREET LANCASTER, WI 53813 | HARTFORD LIFE AND ACCIDENT | $33K | — | $33K | 20.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT PLAN ADMINISTRATION EIN 39-1400101 NONE | Direct payment from the plan; Plan Administrator; Claims processing Service code 12 | — | $413K |
| BLUE CROSS BLUE SHIELD OF WISCONSIN EIN 39-0138065 NONE | Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $242K |
| UNITED HEALTH CARE INSURANCE EIN 36-2739571 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $116K |
| KOVITZ INVESTMENT GROUP PARTNERS NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | 115 SOUTH LASALLE ST., 27TH FLLOR CHICAGO, IL 60603 | $71K |
| LEE JOST & ASSOCIATES EIN 39-1400101 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $60K |
| UMR EIN 36-2739571 NONE | Direct payment from the plan; Contract Administrator; Other fees Service code 13 | — | $32K |
| THE PREVIANT LAW FIRM, S.C. EIN 39-1211596 NONE | Legal; Direct payment from the plan Service code 29 | — | $32K |
| AURORA EMPLOYER SOLUTIONS EIN 39-1442285 NONE | Other fees; Direct payment from the plan Service code 50 | — | $26K |
| FREYBERG HINKLE ASHLAND POWERS & ST EIN 39-1531945 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $18K |
| BMO FINANCIAL GROUP EIN 36-2085229 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $11K |
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 | 837 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 103 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 940 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 940 | $0 |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 937 | $165K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 937 | $165K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 837 | $743K |
| Other | HARTFORD LIFE AND ACCIDENT | 937 | $165K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 940 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.