| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AVERGENT LLC3 | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 8.80% |
| AVERGENT LLC3 | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 9.75% |
| AVERGENT LLC3 | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 14.58% |
| EPSIX, INC.3 | 3300 N SCOTTSDALE RD APT 4020 SCOTTSDALE, AZ 852516579 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 6.82% |
| SALLY ANN WHITE3 | 3310 E PARKSIDE BLVD APT 120 APPLETON, WI 549155628 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 6.58% |
| PAUL W DESPIRITO3 | N 2892 HILLCREST DR HORTONVILLE, WI 54944 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 4.75% |
| SHANNON A LADING3 | 738 W 4TH ST APPLETON, WI 541151059 | CONTINENTAL AMERICAN INSURANCE COMPANY | $226 | — | $226 | 0.84% |
| CHRISTOPHER TARI3 Filed as: CHRISTOPHER JOHN TARI | 1179 WEBBER AVE SOUTH HEMPSTEAD, NY 115508042 | CONTINENTAL AMERICAN INSURANCE COMPANY | $212 | — | $212 | 0.78% |
| KYLE G WHELTON3 Filed as: KYLE GREGORY WHELTON | 133 N JACKSON ST APT 429 MILWAUKEE, WI 532026155 | CONTINENTAL AMERICAN INSURANCE COMPANY | $192 | — | $192 | 0.71% |
| RANDA RENAE SCHINDEL3 | 1270 SCHEURING RD APT 5 DE PERE, WI 541151058 | CONTINENTAL AMERICAN INSURANCE COMPANY | $181 | — | $181 | 0.67% |
| JOHANN S SCRIMSHIRE3 Filed as: JOHANN SCOTT SCRIMSHIRE | 200 S MAIN ST STE 130-405 SEBASTOPOL, CA 954724284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $168 | — | $168 | 0.62% |
| CRISTOPHER BUMBY3 | 836 THOMAS ST RIPON, WI 549711804 | CONTINENTAL AMERICAN INSURANCE COMPANY | $160 | — | $160 | 0.59% |
| PATRICK R RUHLE3 | 102 BILTMORE BLVD MASSAPEQUA, NY 11758 | CONTINENTAL AMERICAN INSURANCE COMPANY | $37 | — | $37 | 0.14% |
| WILLIAM WHICHER3 | 11 KEENAN PL GARDEN CITY, NY 11530 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24 | — | $24 | 0.09% |
| AVERGENT LLC3 | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 10.15% |
| AVERGENT LLC3 | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | WYSSTA INSURANCE COMPANY INC | $663 | — | $663 | 8.00% |
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 | 196 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 197 | $133K |
| Vision(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 197 | $94K |
| Life insurance(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 197 | $112K |
| Short-term disability(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 197 | $112K |
| Long-term disability(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 197 | $112K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 175 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.