| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN-JOHNSON INSURANCE, INC. | PO BOX 259408 MADISON, WI 53725 | DEAN HEALTH PLAN INC. | $29K | — | $29K | 1.13% |
| WELLMARK INC3 Filed as: WELMMARK DIRECT | — | WELLMARK HEALTH PLAN OF IOWA | $0 | — | $0 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 70 LINDEN OAKS SUITE 210 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $69K | — | $69K | 4.13% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $9K | — | $9K | 4.64% |
| TITAN INSURANCE & EMPLOYEE BENEFITS3 | 1 SOUTH CLINTON AVE SUITE 1030 ROCHESTER, NY 14604 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $2K | — | $2K | 0.98% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $5K | — | $5K | 3.74% |
| TITAN INSURANCE & EMPLOYEE BENEFITS3 Filed as: TITAN INSURANCE & EMPLOYEE | 1 SOUTH CLINTON AVENUE ROCHESTER, NY 14604 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $196 | — | $196 | 0.15% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $5K | — | $5K | 6.23% |
| TITAN INSURANCE & EMPLOYEE BENEFITS3 Filed as: TITAN INSURANCE & EMPLOYEE | 1 SOUTH CLINTON AVENUE ROCHESTER, NY 14604 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $162 | — | $162 | 0.19% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INSURANCE INC. | PO BOX 259408 MADISON, WI 53725 | AMERITAS LIFE INSURANCE CORP. | $2K | — | $2K | 6.56% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $899 | — | $899 | 4.63% |
| TITAN INSURANCE & EMPLOYEE BENEFITS3 Filed as: TITAN INSURANCE & EMPLOYEE | 1 SOUTH CLINTON AVE SUITE 1030 ROCHESTER, NY 14604 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $190 | — | $190 | 0.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 7.79% |
| US EMPLOYEE BENEFITS SERVICES GROUP3 Filed as: US EMPLOYEE BENEFITS AND SERVICE | 1 SOUTH CLINTON AVE SUITE 1030 ROCHESTER, NY 14604 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $187 | — | $187 | 1.09% |
| HAUSMANN-JOHNSON INSURANCE INC3 | P O BOX 259408 MADISON, WI 537159408 | DELTA DENTAL OF WISCONSIN | $911 | — | $911 | 6.60% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 3113 WEST BELTLINE HWY MADISON, WI 53713 | FEDERAL INSURANCE COMPANY | $0 | — | $0 | 0.00% |
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 | 791 | 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) | 791 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | DEAN HEALTH PLAN INC. | 571 | $6.5M |
| Dental | DELTA DENTAL OF WISCONSIN | 315 | $14K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 475 | $44K |
| Life insurance | CIGNA LIFE INSURANCE CO. OF NEW YORK | 791 | $184K |
| Short-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 530 | $130K |
| Long-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 767 | $83K |
| Prescription drug(2 contracts, 2 carriers) | WELLMARK HEALTH PLAN OF IOWA | 238 | $4.0M |
| Other(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 791 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 791 | — |
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.