| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $52K | $52K | 4.77% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16K | $0 | $16K | 8.36% |
| SUSAN HENDRICKS3 Filed as: SUSAN HENDRICKS AND OTHER AGENTS | 6718 NORTH PALM CANYON DRIVE PHOENIX, AZ 85018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $806 | $12K | 6.10% |
| CHANDA MANSKE3 | 12145 WEST JESSIE COURT SUN CITY, AZ 85373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $5K | 2.46% |
| BRIAN DOUGLAS SCHROEDER3 | 16356 NORTH THOMPSON PEAK PARKWAY SCOTTSDALE, AZ 85260 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $2K | $4K | 2.29% |
| DAVID DOUGLAS MANSKE3 | 4636 NORTH 94TH LANE PHOENIX, AZ 85037 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 1.57% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 1.22% |
| WILLIAM BRENT MILLER3 | 6339 SAND BAR POINT COLORADO SPRINGS, CO 80923 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $418 | $2K | 1.16% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 318 SOUTH WASHINGTON STREET GREEN BAY, WI 54301 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $1K | $5K | 8.33% |
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 | 202 | 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) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 179 | $1.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 280 | $66K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 280 | $66K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 280 | $66K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 139 | $191K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 179 | $1.1M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 280 | $256K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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.