| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | WISCONSIN COLLABORATIVE INSURANCE COMPANY | $32K | $0 | $32K | 3.25% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $0 | $6K | 10.20% |
| CAMERON SUTTON ROBERTS3 | N9404 ROSELLA DRIVE APPLETON, WI 54915 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $652 | $4K | 6.41% |
| RODNEY JAMES SONNENBERG3 | 432 AMORY STREET FON DU LAC, WI 54935 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $139 | $3K | 4.89% |
| DANIEL FROST3 | 241 POYGAN ROAD OMRO, WI 54963 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $79 | $2K | 3.28% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS | 800 MAIN STREET DUBUQUE, IA 52001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $361 | $0 | $361 | 0.62% |
| ADAM J ZAHN3 Filed as: ADAM J. ZAHN | 725 EAST GRANT STREET APPLETON, WI 54911 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $6 | $47 | 0.08% |
| ENROLLEASE3 Filed as: DIGITAL INSURANCE AND OTHER AGENTS | 200 GALLERIA PARKWAY ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $0 | $41 | 0.07% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | WYSSTA INSURANCE COMPANY INC | $970 | $0 | $970 | 8.38% |
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 | 121 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WISCONSIN COLLABORATIVE INSURANCE COMPANY | 191 | $992K |
| Vision | WYSSTA INSURANCE COMPANY INC | 91 | $12K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 97 | $76K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 97 | $76K |
| Prescription drug | WISCONSIN COLLABORATIVE INSURANCE COMPANY | 191 | $992K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 97 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 191 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.