| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED FINANCIAL GROUP LLC3 | 6000 CLEARWATER DR MINNETONKA, MN 553439448 | METROPOLITAN LIFE INSURANCE COMPANY | $117K | $539 | $118K | 8.06% |
| ASSOCIATED BENEFITS & RISK CON3 | 1217 N TAYLOR DR SHEBOYGAN, WI 53081 | DELTA DENTAL OF WISCONSIN | $11K | — | $11K | 0.82% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GROUP, LLC | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | FOUR EVER LIFE INS. CO. | $352 | $141 | $493 | 13.99% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $342 | — | $342 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $1.1M |
| JEFFREY BARTOSIC BROKER | Insurance agents and brokers Service code 22 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | $24K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $16K |
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 | 2,107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 2,177 | $1.3M |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C. | 5,255 | $209K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 3,325 | $1.5M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 3,325 | $1.5M |
| Other(4 contracts, 4 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 5,258 | $3.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,258 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.