| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 122 EAST COLLEGE AVENUE SUITE 201 APPLETON, WI 54911 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 12.01% |
| THE PAYROLL BENEFITS GROUP PA3 | PO BOX 5395 BRANDON, MS 39047 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 9.15% |
| KME INSURANCE BROKERAGE, INC.3 Filed as: KME INS BROKERAGE INC | 300 S WACKER DR STE 2000-A - BLDG 2 STE 125 CHICAGO, IL 606066736 | METROPOLITAN LIFE INSURANCE COMPANY | $528 | — | $528 | 9.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC | 93033 NETWORK PL CHICAGO, IL 606730001 | METROPOLITAN LIFE INSURANCE COMPANY | $463 | — | $463 | 8.33% |
| THE PAYROLL BENEFITS GROUP PA3 | PO BOX 5395 BRANDON, MS 39047 | ALLSTATE | $652 | — | $652 | 17.51% |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 163 | $911K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $85K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $85K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $85K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $89K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $85K |
| Other(4 contracts, 4 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 177 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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.