| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HCC LIFE INSURANCE COMPANY3 | 225 TOWNPARK DRIVE, SUITE 350 KENNESAW, GA 30144 | HCC LIFE INSURANCE COMPANY | $0 | $31K | $31K | 6.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT PLAN ADMINISTRATION OF WI EIN 39-1400101 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $286K |
| UNITED HEALTH CARE EIN 36-2739571 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $238K |
| MILLIMAN INC. EIN 91-0675641 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $59K |
| THE PREVIANT LAW FIRM NONE | Legal; Direct payment from the plan Service code 29 | 310 WEST WISCONSIN AVE SUITE 100 MW MILWAUKEE, WI 53203 | $37K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $25K |
| AMALGAMATED BANK OF CHICAGO EIN 36-0721895 NONE | Direct payment from the plan; Other investment fees and expenses Service code 50 | — | $24K |
| SIKICH CPA LLC EIN 54-1172176 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $21K |
| AURORA EMPLOYER SOLUTIONS EIN 39-1442285 NONE | Other fees; Direct payment from the plan Service code 50 | — | $15K |
| FIRST STATE BANK NONE | Custodial (other than securities); Account maintenance fees Service code 18 | 220 W WAUPACA ST NEW LONDON, WI 54961 | $8K |
| WEX HEALTH, INC EIN 06-1593514 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $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 | 406 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 173 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 579 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CARE-PLUS DENTAL PLANS, INC. | 89 | $24K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 454 | $507K |
| Other | HCC LIFE INSURANCE COMPANY | 454 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 454 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.