| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TOMPKINS INSURANCE AGENCIES3 Filed as: TOMPKINS INS AGENCIES INC | 90 MAIN STREET BATAVIA, NY 140202109 | METROPOLITAN LIFE INSURANCE COMPANY | $191K | $15K | $206K | 12.30% |
| DONALD SCHULTZ3 | 1820 NICHOLAS DRIVE EAU CLAIRE, WI 54703 | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | $15K | — | $15K | 1.43% |
| TOMPKINS INSURANCE AGENCIES3 Filed as: TOMPKINS INSURANCE AGENCIES, INC. | 1240 BROADCASTING ROAD PO BOX 6707 WYOMISSING, PA 19610 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $28K | — | $28K | 15.00% |
| DONALD SCHULTZ3 | 1820 NICHOLAS DRIVE EAU CLAIRE, WI 54703 | DELTA DENTAL PLAN OF WISCONSIN | $3K | — | $3K | 5.00% |
| TIC INC3 Filed as: TIC INC/THE INSURANCE CENTER | 701 SAND LAKE ROAD ONALASKA, WI 546502442 | THE EPIC LIFE INSURANCE COMPANY | $2K | — | $2K | 7.18% |
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 | 3,835 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 45 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,880 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | 145 | $1.1M |
| Dental | DELTA DENTAL PLAN OF WISCONSIN | 156 | $66K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 4,649 | $1.7M |
| Short-term disability | THE EPIC LIFE INSURANCE COMPANY | 69 | $23K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,835 | $187K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 4,649 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,649 | — |
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.