| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | THREE EMBARCADERO CENTER, SUITE 600 SAN FRANCISCO, CA 94111 | BLUE CROSS AND BLUE SHIELD OF WISCONSIN | $15K | $0 | $15K | 1.05% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS SVCS, LLC | 800 MAIN STREET DUBUQUE, IA 52001 | BLUE CROSS AND BLUE SHIELD OF WISCONSIN | $11K | $0 | $11K | 0.75% |
| LOCKTON COMPANIES, LLC3 | 4275 EXECUTIVE SQUARE, SUITE 600 LA JOLLA, CA 92037 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 9.19% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS SVCS, LLC | 800 MAIN STREET DUBUQUE, IA 52001 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $3K | $5K | 7.59% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET SUITE 5200 LOS ANGELES, CA 90017 | DELTA DENTAL OF WISCONSIN | $5K | $0 | $5K | 6.99% |
| UNKNOWN3 | UNKNOWN WAUKESHA, WI 53188 | WYSSTA INSURANCE COMPANY, INC. | $745 | $0 | $745 | 8.00% |
No Schedule C service providers reported on this filing.
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 | 105 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF WISCONSIN | 164 | $1.5M |
| Dental | DELTA DENTAL OF WISCONSIN | 87 | $68K |
| Vision | WYSSTA INSURANCE COMPANY, INC. | 80 | $9K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 105 | $72K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 105 | $72K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF WISCONSIN | 164 | $1.5M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 105 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.