| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | UNITEDHEALTHCARE INSURANCE COMPANY | $16K | $0 | $16K | 1.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $2K | $2K | 0.15% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 8.33% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $4K | $4K | 4.62% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | DELTA DENTAL OF WISCONSIN | $5K | $0 | $5K | 6.94% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $1K | $0 | $1K | 10.00% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 15.00% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $494 | $494 | 5.00% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | MANHATTANLIFE | $102 | $0 | $102 | 6.26% |
| THOMAS M. BARTZ3 | 435 EAST MILL STREET, STOP 6 PLYMOUTH, WI 53073 | MANHATTANLIFE | $23 | $0 | $23 | 1.41% |
| BENEFITS INC3 Filed as: BENEFITS INC. | 250 NORTH PATRICK BOULEVARD SUITE 100 BROOKFIELD, WI 53045 | MANHATTANLIFE | $14 | $0 | $14 | 0.86% |
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 | 101 | 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) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 128 | $1.6M |
| Dental | DELTA DENTAL OF WISCONSIN | 85 | $76K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 165 | $14K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 98 | $89K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 98 | $80K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 128 | $1.6M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 101 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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.