Form 5500 · Employee benefit plan · MADISON, WI
BRIGHTSTAR WI OPERATIONS, LLC
The filing calls this plan BRIGHTSTAR WI OPERATIONS, LLC HEALTH AND WELFARE PLAN.
BRIGHTSTAR WI OPERATIONS, LLC of MADISON, WI files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is ACRISURE OF CALIFORNIA LLC DBA. Coverage is written through AETNA LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in February.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 92-0433039 · plan 501 · plan year 2024, filed Oct 8, 2024
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How this plan is funded
Self-funded as reported
The plan's financial statement reports paying insurance carriers far less than the premium on its insurance contracts, so most benefits were paid from plan money.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 2 insured contracts covering health, dental, vision and life; the largest, with AETNA LIFE INSURANCE COMPANY, covers 345 people.
Reported premium across the insured contracts is $2,552,758, with $38,313 in disclosed broker commissions — about 1.5% of premium.
The most recent policy period ended in February, and the plan year ends February 29. Group contracts typically renew on that annual cycle.
ACRISURE OF CALIFORNIA LLC DBA is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Two carriers split the book: AETNA LIFE INSURANCE COMPANY and HARTFORD LIFE AND ACCIDENT.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY | Health, Dental, Vision | 345 | Mar 1, 2024 | $2,447,954 | $24,382 |
| HARTFORD LIFE AND ACCIDENT | Life | 329 | Mar 1, 2024 | $104,804 | $13,931 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule I
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
How this plan compares
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