| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT E. MILLER INSURANCE AGENCY3 | 903 EAST 104TH STREET, SUITE 800 KANSAS CITY, MO 64131 | SUN LIFE ASSURANCE COMPANY OF CANADA | $64K | $38K | $102K | 9.79% |
| ROBERT E. MILLER INSURANCE AGENCY3 | 903 EAST 104TH STREET, SUITE 800 KANSAS CITY, MO 64131 | SUN LIFE ASSURANCE COMPANY OF CANADA | $79K | $14K | $94K | 25.41% |
| ROBERT E. MILLER INSURANCE AGENCY3 | 903 EAST 104TH STREET, SUITE 800 KANSAS CITY, MO 64131 | UNITED HEALTHCARE INSURANCE COMPANY | $28K | — | $28K | 10.86% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 903 EAST 104TH STREET, SUITE 800 KANSAS CITY, MO 64131 | LINCOLN NATIONAL LIFE INSURANCE | $5K | — | $5K | 3.00% |
| JENNINGS INSURANCE SERVICES3 Filed as: JENNINGS INSURANCE SERVICES INC. | 10524 MOSS PARK ROAD ORLANDO, FL 32832 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 3.00% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 903 EAST 104TH STREET, SUITE 800 KANSAS CITY, MO 64131 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 3.00% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 903 EAST 104TH STREET, SUITE 800 KANSAS CITY, MO 64131 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $13K | — | $13K | 11.44% |
| WORKPLACE SOLUTIONS, INC.3 Filed as: WORKPLACE SOLUTIONS, INC | 120A GILLS CREEK PARKWAY COLUMBIA, SC 29209 | RELIASTAR LIFE INSURANCE COMPANY | $488 | — | $488 | 1.42% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GROUP, LLC | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIASTAR LIFE INSURANCE COMPANY | $244 | — | $244 | 0.71% |
| BEAU DAVID BOUDREAUX3 Filed as: BEAU D. BOUDREAUX | 120 A GILLS CREEK PARKWAY COLUMBIA, SC 29209 | RELIASTAR LIFE INSURANCE COMPANY | $61 | — | $61 | 0.18% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $73 | — | $73 | 7.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MGMT. | Float revenue; Claims processing; Other fees; Direct payment from the plan Service code 12 | — | $5.6M |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $715K |
| ROBERT E. MILLER INSURANCE AGENCY EIN 43-0902269 BROKER | Insurance agents and brokers; Other commissions Service code 22 | — | $232K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $95K |
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 | 2,527 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 60 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,587 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 4,111 | $258K |
| Life insurance(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,527 | $1.2M |
| Short-term disability(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 4,920 | $1.2M |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 4,920 | $1.2M |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 2,016 | $2.5M |
| Other(6 contracts, 5 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,527 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,920 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.