| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN GROUP- HG | 740 REGENT STREET #400 MADISON, WI 53715 | DEAN HEALTH PLAN INC | $21K | — | $21K | 2.17% |
| OBERLOH, JESSE D3 | HAUSMANN GROUP 740 REGENT ST. #400 MADISON, WI 53725 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $27K | — | $27K | 4.17% |
| CHASE JR, THEODORE W3 Filed as: TC CHASE AND ASSOCIATES LLC | PO BOX 316 SUN PRAIRIE, WI 53590 | DELTA DENTAL OF WISCONSIN | $10K | — | $10K | 7.32% |
| CHASE JR, THEODORE W3 | 206 WINDSOR ST SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.47% |
| HELMAN, TIMOTHY J3 | 2550 STONEHAVEN DRIVE SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.47% |
| CHASE JR, THEODORE W3 | 206 WINDSOR ST SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 7.46% |
| HELMAN, TIMOTHY J3 | 2550 STONEHAVEN DRIVE SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 7.46% |
| CARUTH, JENNON, M3 | 7825 WASHINGTON AVE S STE 710 BLOOMINGTON, MN 55439 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 9.71% |
| CHASE JR, THEODORE W3 | 206 WINDSOR ST SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 5.28% |
| CHASE JR, THEODORE W3 | 206 WINDSOR ST SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $152 | — | $152 | 2.27% |
| CARUTH, JENNON, M3 | 7825 WASHINGTON AVE S STE 710 BLOOMINGTON, MN 55439 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $105 | $1 | $106 | 1.59% |
| HELMAN, TIMOTHY J3 Filed as: HELMAN, TIMOTHY, JON | 2550 STONEHAVEN DRIVE SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $70 | — | $70 | 1.05% |
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 | 303 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 36 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 345 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | DEAN HEALTH PLAN INC | 159 | $1.6M |
| Dental | DELTA DENTAL OF WISCONSIN | 176 | $137K |
| Vision | WYSSTA INSURANCE COMPANY | 134 | $22K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 388 | $109K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 41 | $32K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 388 | $109K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 388 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 388 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.