| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $60K | $60K | 2.64% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-WI | 1217 N TAYLOR DR SHEBOYGAN, WI 53081 | DELTA DENTAL OF WISCONSIN | $11K | — | $11K | 0.92% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $14K | — | $14K | 2.68% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $27K | — | $27K | 5.70% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $21K | — | $21K | 6.86% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 6000 CLEARWATER DR MINNETONKA, MN 553439448 | METROPOLITAN LIFE INSURANCE COMPANY | $42K | $9K | $51K | 19.22% |
| ANTHEM INSURANCE COMPANIES, INC.3 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 46204 | 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 | $296 | — | $296 | 15.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE EIN 62-0427913 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $1.1M |
| LINCOLN LIFE ASSURANCE COMPANY EIN 04-6076039 CLAIMS PROCESSING | Claims processing Service code 12 | — | $78K |
| JEFFREY BARTOSIC BROKER | Insurance agents and brokers Service code 22 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | $23K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | — | $15K |
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 | 1,898 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 30 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 41 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,969 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 1,939 | $1.2M |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C. | 4,664 | $187K |
| Life insurance(2 contracts, 2 carriers) | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 3,288 | $735K |
| Short-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 3,248 | $524K |
| Long-term disability(2 contracts, 2 carriers) | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 3,288 | $575K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,937 | $2.3M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 3,288 | $270K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,664 | — |
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.