| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAUSMANN GROUP INC3 | 740 REGENT STREET SUITE 400 MADISON, WI 53715 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $27K | — | $27K | 2.41% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP | PO BOX 259408 MADISON, WI 537159408 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 5.55% |
| HAUSMANN GROUP INC3 | PO BOX 259408 MADISON, WA 53725 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| HAUSMANN GROUP INC3 | PO BOX 259408 MADISON, WI 53725 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP | PO BOX 259408 MADISON, WI 53725 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP | PO BOX 259408 MADISON, WI 537159408 | WYSSTA INSURANCE COMPANY INC | $2K | — | $2K | 15.00% |
| HAUSMANN-JOHNSON INSURANCE INC - MI3 Filed as: HAUSMANN GROUP IN | PO BOX 259408 MADISON, WI 53725 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $834 | — | $834 | 12.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $9K |
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 | 162 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 137 | $1.1M |
| Dental | DELTA DENTAL OF WISCONSIN | 133 | $94K |
| Vision | WYSSTA INSURANCE COMPANY INC | 128 | $12K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 117 | $7K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 113 | $53K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 110 | $43K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 137 | $1.1M |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 137 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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.