| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAUSMANN GROUP INC3 | 740 REGENT ST SUITE 400 MADISON, WI 53715 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $19K | — | $19K | 1.70% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP, INC | 740 REGENT STREET SUITE 400 MADISON, WI 53715 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $458 | $3K | 9.71% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $143 | $143 | 0.41% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP, INC | 740 REGENT STREET SUITE 400 MADISON, WI 53715 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $230 | $2K | 12.32% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $72 | $72 | 0.41% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP, INC | 740 REGENT STREET SUITE 400 MADISON, WI 53715 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $210 | $3K | 15.98% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $66 | $66 | 0.41% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP, INC | 740 REGENT STREET SUITE 400 MADISON, WI 53715 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $59 | $5 | $64 | 16.24% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $2 | $2 | 0.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 TPA (DENTAL BENEFIT) | Contract Administrator Service code 13 | — | $4K |
| HAUSMANN GROUP INSURANCE AGENT | Insurance agents and brokers Service code 22 | PO BOX 259408 MADISON, WI 537159408 | $1K |
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 | 156 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | 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) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 156 | $1.1M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 98 | $17K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 98 | $35K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 98 | $16K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 156 | $1.1M |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 98 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.