| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | 101 E. GRAND AVE. SUITE 11 PORT WASHINGTON, WI 53074 | HARTFORD LIFE AND ACCIDENT | $93K | $11K | $104K | 10.71% |
| WEBTPA EMPLOYER SERVICES LLC3 Filed as: WEBTPA EMPLOYER SERVICES | 8500 FREEPORT PARKWAY SOUTH IRVING, TX 75063 | HARTFORD LIFE AND ACCIDENT | — | $4K | $4K | 0.45% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES | 101 E. GRAND AVE. PORT WASHINGTON, WI 53074 | SUN LIFE ASSURANCE COMPANY | — | $28K | $28K | 3.14% |
| UMR, INC.3 Filed as: UMR INC. | 11 SCOTT STREET SUITE 100 WAUSAU, WI 54403 | SUN LIFE ASSURANCE COMPANY | — | $6K | $6K | 0.66% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES | 888 STATE HIGHWAY 153 SUITE 200 MOSINEE, WI 54455 | ARMADA CARE | $750 | — | $750 | 1.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX INC EIN 33-0441200 PHARMACY BENEFIT MGMT | Claims processing; Direct payment from the plan; Float revenue; Other fees Service code 12 | — | $1.7M |
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $404K |
| DELTA DENTAL EIN 39-6094742 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | — | $43K |
| ANSAY & ASSOCIATES EIN 27-1304628 BROKER | Insurance agents and brokers Service code 22 | — | $21K |
| NATIONAL VISION ADMINISTRATORS EIN 74-3033381 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $9K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Claims processing Service code 12 | — | $3K |
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 | 1,155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,384 | $967K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,384 | $967K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,384 | $967K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY | 1,043 | $882K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,384 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,384 | — |
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.