| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND, LLC | 2000 CHAPEL VIEW BLVD, SUITE 240 CRANSTON, RI 02920 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $448 | $3K | 18.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC. EIN 39-1400101 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $184K |
| BLUE CROSS BLUE SHIELD OF WISCONSIN EIN 39-0138065 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $111K |
| LEE JOST & ASSOCIATES EIN 39-1400101 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $88K |
| THE PREVIANT LAW FIRM, S.C. EIN 39-1211596 NONE | Legal; Direct payment from the plan Service code 29 | — | $34K |
| SIKICH CPA LLC EIN 54-1172176 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $26K |
| US BANK N.A. EIN 86-0441303 NONE | Investment management fees paid directly by plan; Direct payment from the plan; Custodial (securities); Investment management Service code 19 | — | $23K |
| MEDEXPERT INTERRNATIONAL, INC. EIN 94-3360248 NONE | Other fees Service code 99 | PO BOX 7550 MENLO PARK, CA 94026 | $22K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $18K |
| STRATEGIC CAPITAL INVESTMENT EIN 36-4268991 NONE | Investment advisory (plan); Consulting fees Service code 27 | — | $18K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $9K |
| AURORA EMPLOYER SOLUTIONS EIN 39-1442285 NONE | Direct payment from the plan; Other fees Service code 50 | — | $9K |
| WEX HEALTH, INC. EIN 06-1593514 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $8K |
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 | 345 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 354 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 322 | $15K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 322 | $15K |
| Stop-loss / reinsurancereinsurance | PARTNERRE AMERICA INSURANCE CO | 322 | $426K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 322 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.