| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AXION RMS LTD3 | 2443 WARRENVILLE RD SUITE 610 LISLE, IL 60532 | METROPOLITAN LIFE INSURANCE COMPANY | — | $15K | $15K | 1.04% |
| AXION RMS LTD3 | 2443 WARRENVILLE RD SUITE 610 LISLE, IL 60532 | RELIASTAR LIFE INSURANCE COMPANY | $84K | — | $84K | 20.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF WISCONSIN EIN 39-0138065 | Contract Administrator; Claims processing; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $810K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $69K |
| INGENIORX, INC. EIN 82-3062245 | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Claims processing Service code 12 | — | $8K |
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 | 2,906 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,906 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WYSSTA INSURANCE COMPANY INC. | 1,304 | $142K |
| Vision | WYSSTA INSURANCE COMPANY INC. | 1,304 | $142K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 2,906 | $1.5M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,906 | $1.5M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,906 | $1.5M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,906 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,906 | — |
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.