| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAUSMANN GROUP INC3 | PO BOX 259408 MADISON, WI 53725 | DEAN HEALTH PLAN INC | $21K | — | $21K | 1.83% |
| OBERLOH, JESSE D3 | HAUSMANN GROUP 740 REGENT ST. #400 MADISON, WI 53715 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $31K | — | $31K | 3.93% |
| CHASE JR, THEODORE W3 | 206 WINDSOR ST SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 3.07% |
| HELMAN, TIMOTHY J3 | 2550 STONEHAVEN DRIVE SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 3.07% |
| CHASE JR, THEODORE W3 Filed as: TC CHASE AND ASSOCIATES LLC | PO BOX 316 SUN PRAIRIE, WI 53590 | DELTA DENTAL OF WISCONSIN | $10K | — | $10K | 8.12% |
| JESSE OBERLOH3 | PO BOX 259408 MADISON, WI 53725 | PREVEA360 HEALTH PLAN | $3K | — | $3K | 2.90% |
| CHASE JR, THEODORE W3 | 206 WINDSOR ST SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 7.54% |
| HELMAN, TIMOTHY J3 | 2550 STONEHAVEN DRIVE SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 7.54% |
| CHASE JR, THEODORE W3 | 206 WINDSOR ST SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 7.52% |
| HELMAN, TIMOTHY J3 | 2550 STONEHAVEN DRIVE SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 7.52% |
| CARUTH, JENNON, M3 | 7825 WASHINGTON AVE S STE 710 BLOOMINGTON, MN 55439 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $100 | $2K | 11.97% |
| CHASE JR, THEODORE W3 | 206 WINDSOR ST SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 6.17% |
| CARUTH, JENNON, M3 | 7825 WASHINGTON AVE S STE 710 BLOOMINGTON, MN 55439 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $62 | $1K | 16.25% |
| CHASE JR, THEODORE W3 | 206 WINDSOR ST SUN PRAIRIE, WI 53590 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $534 | — | $534 | 8.02% |
| HELMAN, TIMOTHY J3 Filed as: HELMAN, TIMOTHY, JON | 2550 STONEHAVEN DRIVE SUN PRAIRIE, WI 53590 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $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 | 466 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 486 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | DEAN HEALTH PLAN INC | 153 | $2.0M |
| Dental | DELTA DENTAL OF WISCONSIN | 158 | $120K |
| Vision | WYSSTA INSURANCE COMPANY | 127 | $20K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 490 | $175K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 38 | $33K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 490 | $155K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 490 | $198K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 490 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.