| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | 101 E GRAND AVE, SUITE 11 PORT WASHINGTON, WI 50833 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $37K | $37K | 4.05% |
| FMLASOURCE INC3 Filed as: FMLASOURCE INC. | 455 N CITYFRONT PLAZA DRIVE-13TH FL CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 20.71% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | 101 E. GRAND AVE - SUITE 200 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $540 | $5K | 16.86% |
| ASCENTIS5 | 11995 SINGLETREE LANE -SUITE 400 EDEN PRAIRIE, MN 55344 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 11.00% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATS, LLC | 101 E. GRAND AVE. - STE 200 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $265 | $2K | 11.72% |
| ASCENTIS5 | 11995 SINGLETREE LANE-SUITE 400 EDEN PRAIRIE, MN 55344 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 11.00% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | 101 E GRAND AVE-STE 11 PORT WASHINGTON, WI 53074 | WYSSTA INSURANCE COMPANY, INC. | $1K | — | $1K | 8.00% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | 101 E GRAND AVE.-STE 200 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $251 | $2K | 16.68% |
| ANCENTIS5 | 11995 SINGLETREE LANE - SUITE 400 EDEN PRAIRIE, MN 55344 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 11.00% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | 101 E GRAND AVE-STE. 200 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $142 | $1K | 16.69% |
| ASCENTIS5 | 11995 SINGLETREE LANE-STE 400 EDEN PRAIRIE, MN 55344 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $924 | $924 | 11.00% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATION, LLC | 101 E GRAND AVE - SUITE 200 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $637 | $119 | $756 | 11.88% |
| ASCENTIS5 | 11995 SINGLETREE LANE-SUITE 400 EDEN PRAIRIE, MN 55344 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $700 | $700 | 11.00% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | 101 E. GRAND AVE - SUITE 200 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $620 | $127 | $747 | 18.07% |
| ASCENTIS5 | 11995 SINGLETREE LANE-STE 400 EDEN PRAIRIE, MN 55344 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $455 | $455 | 11.01% |
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 | 160 | 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) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 162 | $911K |
| Vision | WYSSTA INSURANCE COMPANY, INC. | 141 | $15K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $29K |
| Short-term disability(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $30K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 49 | $15K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 162 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.