| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE BENEFIT WORKS LLC3 Filed as: THE BENEFIT WORKS | 6200 MINERAL POINT RD MADISON, WI 53705 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $19K | — | $19K | 2.34% |
| THE BENEFITWORKS LLC3 Filed as: THE BENEFITWORKS | 6200 MINERAL POINT RD STE 201 MADISON, WI 53705 | DELTA DENTAL OF WISCONSIN | $6K | — | $6K | 8.26% |
| THE BENEFITWORKS LLC3 | 6200 MINERAL POINT RD MADISON, WI 53705 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| THE BENEFITWORKS LLC3 | 6200 MINERAL POINT RD MADISON, WI 53705 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| THE BENEFITWORKS LLC3 | 6200 MINERAL POINT RD MADISON, WI 53705 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 14.74% |
| THE BENEFITWORKS LLC3 | 6200 MINERAL POINT RD STE 201 MADISON, WI 53705 | WYSSTA INSURANCE COMPANY INC | $1K | — | $1K | 8.69% |
| THE BENEFIT WORKS LLC4 | 6200 MINERAL POINT RD MADISON, WI 53705 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 17.24% |
| HEARTLAND BENEFITS GROUP LLC4 | 3120 CASTLETON XING SUN PRAIRIE, WI 53590 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $164 | — | $164 | 2.69% |
| THE BENEFITWORKS LLC3 | 6200 MINERAL POINT RD MADISON, WI 53705 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $225 | — | $225 | 10.02% |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 197 | $831K |
| Dental | DELTA DENTAL OF WISCONSIN | 90 | $79K |
| Vision | WYSSTA INSURANCE COMPANY INC | 70 | $13K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $29K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 76 | $25K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $16K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 197 | $831K |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.