| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GOODRUM, PHILLIP, PORTER3 Filed as: GOODRUM, PHILLIP P | 131 HILLSIDE AVE CHARLOTTE, NC 28209 | RELIASTAR LIFE INSURANCE | $46K | — | $46K | 26.90% |
| IBENEFIT COMMUNICATION LLC3 | 4400 PARK RD STE 311 CHARLOTEE, NC 28209 | RELIASTAR LIFE INSURANCE | $28K | — | $28K | 16.38% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | RELIASTAR LIFE INSURANCE | $6K | — | $6K | 3.51% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | RELIASTAR LIFE INSURANCE | $6K | — | $6K | 3.22% |
| IBENEFIT COMMUNICATION LLC3 | 131 HILLSIDE AVE CHARLOTTE, NC 28209 | RELIASTAR LIFE INSURANCE | $5K | — | $5K | 2.82% |
| AXION RMS LTD3 Filed as: AXION RMS | 2443 WARRENVILLE RD. SUITE 610 LISLE, IL 60532 | RELIASTAR LIFE INSURANCE | $4K | — | $4K | 2.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF WI EIN 39-0138065 ADMINISTRATOR | Other services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.4M |
| DELTA DENTAL OF WI EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $66K |
| INGENIO RX, INC. EIN 82-3062245 ADMINISTRATOR | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Contract Administrator Service code 12 | — | -$470K |
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 | 2,058 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,058 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC. | 1,315 | $136K |
| Life insurance(4 contracts) | SYMETRA LIFE INSURANCE COMPANY | 912 | $1.4M |
| Short-term disability(4 contracts) | SYMETRA LIFE INSURANCE COMPANY | 912 | $1.4M |
| Long-term disability(4 contracts) | SYMETRA LIFE INSURANCE COMPANY | 912 | $1.4M |
| Other(6 contracts, 3 carriers) | SYMETRA LIFE INSURANCE COMPANY | 1,632 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,632 | — |
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.