| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRACY KLEIST3 | 2190A EAST CAPITOL DR STE 1 APPLETON, WI 54911 | WPS HEALTH PLAN, INC. | $24K | — | $24K | 3.90% |
| COTTINGHAM & BUTLER3 | 300 SECURITY BUILDING DUBUQUE, IA 52001 | DELTA DENTAL OF WISCONSIN | $4K | — | $4K | 9.16% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER | 800 MAIN ST DUBUQUE, IA 52004 | COMPANION LIFE INSURANCE COMPANY | $3K | — | $3K | 10.74% |
| HEARTLANDS BENEFITS GROUP LLC3 | PO BOX 41 SUN PRAIRIE, WI 53590 | COMPANION LIFE INSURANCE COMPANY | $2K | — | $2K | 5.37% |
| EMILY N WAYNE3 | 1750 N CLYBOURN AVE APT 202 CHICAGO, IL 60614 | AFLAC | $456 | — | $456 | 5.08% |
| THE BENEFIT WORKS LLC3 | 6200 MINERAL POINT RD MADISON, WI 53705 | AFLAC | $214 | — | $214 | 2.39% |
| CASEY J HIGGINS3 | 9347 LIZARD ROCK TRL COLORADO SPRINGS, CO 80924 | AFLAC | $151 | — | $151 | 1.68% |
| JASON SCZEPANIAK3 | 1161 HERITAGE CT SUN PRARIE, WI 53590 | AFLAC | $30 | — | $30 | 0.33% |
| MICHAEL FRASIER3 | 258 CORPORATE DR STE 200 MADISON, WI 53714 | AFLAC | $9 | — | $9 | 0.10% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER, INC | PO BOX 28 DUBUQUE, IA 520040028 | VISION SERVICE PLAN | $130 | — | $130 | 1.99% |
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 | 146 | 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) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WPS HEALTH PLAN, INC. | 65 | $625K |
| Dental | DELTA DENTAL OF WISCONSIN | 83 | $42K |
| Vision | VISION SERVICE PLAN | 73 | $7K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 146 | $30K |
| Short-term disability | COMPANION LIFE INSURANCE COMPANY | 146 | $30K |
| Other(3 contracts, 3 carriers) | WPS HEALTH PLAN, INC. | 146 | $664K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 146 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.