| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED BENEFITS & RISK CON3 Filed as: ASSOCIATED BENEFITS AND RISK | 711 EISENHOWER DR KIMBERLY, WI 54136 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | — | $17K | 6.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI FINANCIAL SERVICES LLC | 711 EISENHOWER DR KIMBERLY, WI 54136 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 3.06% |
| ASSOCIATED BENEFITS & RISK CON3 Filed as: ASSOCIATED BENEFITS AND RISK | 711 EISENHOWER DR KIMBERLY, WI 54136 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 6000 CLEARWATER DR MINNETONKA, MN 55343 | VISION SERVICE PLAN | — | $2K | $2K | 4.03% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GROUP, LLC | 6000 CLEARWATER DR MINNETONKA, MN 55343 | VISION SERVICE PLAN | — | $67 | $67 | 0.18% |
| ASSOCIATED BENEFITS & RISK CON3 Filed as: ASSOCIATED BENEFITS AND RISK | 711 EISENHOWER DR KIMBERLY, WI 54136 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 6.25% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $979 | — | $979 | 2.84% |
| ASSOCIATED FINANCIAL GROUP LLC4 | 711 EISENHOWER DR KIMBERLY, WI 54136 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $2K | — | $2K | 12.01% |
| STEVE BAKER4 | 153 ESTHER DR COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $933 | — | $933 | 4.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MN EIN 41-0984460 CONTRACT ADMINISTRATOR | Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | PO BOX 64560 ST PAUL, MN 55164 | $581K |
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 | 730 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 737 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 263 | $37K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 730 | $247K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 314 | $34K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 727 | $86K |
| Other | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | 69 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 730 | — |
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.