| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORATION | $11K | $2K | $13K | 3.77% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | HUMANA INSURANCE COMPANY | $2K | $0 | $2K | 3.32% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | HUMANA INSURANCE COMPANY | $1K | $0 | $1K | 2.26% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 100 NORTH CORPORATE DRIVE SUITE 100 BROOKFIELD, WI 53045 | HUMANA INSURANCE COMPANY | $0 | $19 | $19 | 0.03% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $64 | $1K | 9.39% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $698 | $45 | $743 | 5.18% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $29 | $29 | 0.20% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 10.85% |
| JEAN STEINMETZ3 | 1175 VERANDA COURT BROOKFIELD, WI 53005 | AFLAC | $391 | $20 | $411 | 3.85% |
| MJ INSURANCE3 Filed as: JACK D. BREES AND VARIOUS AGENTS | 2989 SOUTH WAUKESHA ROAD WEST ALLIS, WI 53227 | AFLAC | $216 | $4 | $220 | 2.06% |
| JAMEY MILLER INC3 | 6270 TERRACE VIEW LANE SE AUBURN, WA 98092 | AFLAC | $184 | $0 | $184 | 1.72% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 100 NORTH CORPORATE DRIVE SUITE 100 BROOKFIELD, WI 53045 | AFLAC | $111 | $0 | $111 | 1.04% |
| CHRISTINE LOGSLETT3 Filed as: CHRISTINE M. LOGSLETT | 8318 ANNA AVENUE WIND LAKE, WI 53185 | AFLAC | $107 | $0 | $107 | 1.00% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | AFLAC | $103 | $0 | $103 | 0.96% |
| JOSEPH P HOFFMAN3 Filed as: JOSEPH P. HOFFMAN | 601 NORTH THORNBUSH CIRCLE HARTLAND, WI 53029 | AFLAC | $56 | $4 | $60 | 0.56% |
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 | 128 | 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) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORATION | 46 | $400K |
| Dental | HUMANA INSURANCE COMPANY | 46 | $60K |
| Vision | HUMANA INSURANCE COMPANY | 46 | $60K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 128 | $26K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 48 | $14K |
| Prescription drug(2 contracts, 2 carriers) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORATION | 46 | $400K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 128 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 128 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.