| 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 | $0 | $60K | $60K | 3.10% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | KAISER FOUNDATION HEALTH PLAN INC | $12K | $0 | $12K | 3.82% |
| 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 | $17K | $0 | $17K | 10.57% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $8K | $8K | 4.96% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | DELTA DENTAL OF WISCONSIN | $9K | $0 | $9K | 6.44% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | WYSSTA INSURANCE COMPANY | $2K | $0 | $2K | 8.00% |
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 | 478 | 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) | 478 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 347 | $2.3M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 271 | $169K |
| Vision | WYSSTA INSURANCE COMPANY | 240 | $26K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 478 | $164K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 478 | $164K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 478 | $164K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 347 | $2.3M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 478 | $164K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 478 | — |
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."
No prospect flags tripped on this filing.