| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | $28K | $32K | 3.53% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 555 MAIN STREET, SUITE 291 RACINE, WI 53403 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $4K | $4K | 0.43% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 111 NORTH WASHINGTON STREET SUITE 300 GREEN BAY, WI 54301 | UNITEDHEALTHCARE INSURANCE COMPANY | -$4K | $0 | -$4K | -0.44% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 2.24% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | DELTA DENTAL OF WISCONSIN | $5K | $0 | $5K | 7.56% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 11.91% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 6.57% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 555 MAIN STREET, SUITE 294 RACINE, WI 53403 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.94% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | WYSSTA INSURANCE COMPANY | $1K | $0 | $1K | 8.59% |
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 | 230 | 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) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 108 | $1.2M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 143 | $85K |
| Vision | WYSSTA INSURANCE COMPANY | 121 | $13K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 230 | $68K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 230 | $68K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 230 | $68K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 108 | $1.2M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 230 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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.