| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 510187 NEW BERLIN, WI 53151 | UNITEDHEALTHCARE INSURANCE COMPANY | $15K | $0 | $15K | 7.09% |
| HAYS COMPANIES, INC.3 | 1200 NORTH MAYFAIR ROAD, SUITE 100 MILWAUKEE, WI 53226 | DELTA DENTAL OF WISCONSIN | $874 | $0 | $874 | 0.54% |
| HNI RISK SERVICES3 | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $4K | $0 | $4K | 9.15% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | CARE-PLUS DENTAL PLANS, INC. | $1K | $0 | $1K | 7.20% |
| HAYS COMPANIES, INC.3 | 1200 NORTH MAYFAIR ROAD, SUITE 100 MILWAUKEE, WI 53226 | CARE-PLUS DENTAL PLANS, INC. | $139 | $0 | $139 | 0.81% |
No Schedule C service providers reported on this filing.
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 | 593 | 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) | 593 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 255 | $179K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 241 | $45K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 593 | $216K |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 593 | $216K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 593 | $216K |
| Other(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 593 | $226K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 593 | — |
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.