| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WI, INC. | 2323 N MAYFAIR ROAD STE 600 MILWAUKEE, WI 53226 | SYMETRA LIFE INSURANCE COMPANY | $21K | $8K | $29K | 13.67% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 400 N EXECUTIVE DRIVE STE 300 BROOKFIELD, WI 53005 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | $13K | $15K | 110.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WI INC. | 400 N EXECUTIVE DR. STE 300 BROOKFIELD, WI 53005 | CIGNA GROUP INSURANCE | — | $9K | $9K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 22561 NETWORK PLACE CHICAGO, IL 60673 | $148K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 1233 N MAYFAIR ROAD STE. 204 MILWAUKEE, WI 53226 | $13K |
| WILLIS OF WISCONSIN INC. EIN 39-6094742 STEVE DUCKETT, AGENT | Insurance agents and brokers Service code 22 | PO BOX 1650 MILWAUKEE, WI 53201 | $768 |
| PRUDENTIAL INSURANCE CO OF AMERICA EIN 22-1211670 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 7827 PHILADELPHIA, PA 19176 | $0 |
| WILLIS OF WISCONSIN, INC. EIN 39-0765647 BROKER | Other commissions Service code 55 | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | $0 |
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 | 257 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 476 | $13K |
| Life insurance | CIGNA GROUP INSURANCE | 0 | $0 |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 266 | $210K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 476 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.