| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 640 GREEN BAY, WI 54305 | HARTFORD LIFE AND ACCIDENT | $39K | — | $39K | 16.35% |
| USI INSURANCE SERVICES LLC3 | 6000 CLEARWATER DRIVE MINNETONKA, MN 553439448 | HARTFORD LIFE AND ACCIDENT | — | $12K | $12K | 5.11% |
| UMR, INC.3 Filed as: UMR INC | 2700 MIDWEST DRIVE ONALASKA, WI 54602 | WESTPORT INSURANCE CORP | — | $143K | $143K | 67.29% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE ATTN COMMISSIONS DEPT KIMBERLY, WI 54136 | WESTPORT INSURANCE CORP | — | $3K | $3K | 1.63% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | WESTPORT INSURANCE CORP | — | $2K | $2K | 1.17% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | VISION SERVICE PLAN | — | $186 | $186 | 0.75% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 21.27% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 541362142 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 3RD PARTY ADMIN - DENTAL | Contract Administrator Service code 13 | — | $12K |
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 | 504 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 504 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WESTPORT INSURANCE CORP | 256 | $213K |
| Vision | VISION SERVICE PLAN | 251 | $25K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 435 | $239K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 435 | $239K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 435 | $239K |
| Stop-loss / reinsurancereinsurance | WESTPORT INSURANCE CORP | 256 | $213K |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 435 | $261K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 435 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.