| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PRITCHARD & JERDEN INC3 Filed as: PRITCHARD AND JERDEN INC. | 950 E. PACES FERRY ROAD, NE SUITE 2000 ATLANTA, GA 30326 | UNITED HEALTHCARE OF WISCONSIN, INC. | $7K | — | $7K | 1.55% |
| PRITCHARD & JERDEN INC3 Filed as: PRITCHARD AND JERDEN INC. | 950 E. PACES FERRY ROAD, NE SUITE 2000 ATLANTA, GA 30326 | UNITED HEALTHCARE OF WISCONSIN, INC. | $276 | — | $276 | 1.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH, INC. EIN 16-1264154 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $107K |
| CONDUENT HR CONSULTING, LLC EIN 13-3954297 NONE | Investment management; Direct payment from the plan Service code 28 | — | $27K |
| LJ MOSBY, P.C. EIN 84-1656069 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $20K |
| SUNTRUST BANK EIN 62-1644863 NONE | Float revenue; Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $9K |
| THE ESI OPERATING COMPANY EIN 22-3461740 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $6K |
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 | 86 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 98 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | UNITED HEALTHCARE OF WISCONSIN, INC. | 110 | $437K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 110 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.