| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $15K | $0 | $15K | 2.31% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | HUMANA INSURANCE COMPANY | $3K | $1K | $4K | 10.82% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $450 | $4K | 17.36% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 9.76% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $895 | $895 | 5.00% |
| JEAN STEINMETZ3 | 1175 VERANDA COURT BROOKFIELD, WI 53005 | AFLAC | $1K | $169 | $2K | 8.98% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | AFLAC | $1K | $0 | $1K | 5.77% |
| MORGAN E MARKOWSKI3 Filed as: MORGAN E. MARKOWSKI | 1616 SOUTH 167TH STREET NEW BERLIN, WI 53151 | AFLAC | $398 | $40 | $438 | 2.46% |
| DEBRA S. HERBERS AND OTHER AGENTS3 | 410 PRAIRIE MEADOW DRIVE BLUE GRASS, IA 52726 | AFLAC | $258 | $0 | $258 | 1.45% |
| JAMEY MILLER INC3 Filed as: JAMEY MILLER, INC. | 12942 193RD AVENUE EAST BONNEY LAKE, WA 98391 | AFLAC | $192 | $0 | $192 | 1.08% |
| CHRISTINE LOGSLETT3 Filed as: CHRISTINE M. LOGSLETT | 8318 ANNA AVENUE WIND LAKE, WI 53185 | AFLAC | $110 | $0 | $110 | 0.62% |
| JACK D BREES3 Filed as: JACK D. BREES | 2989 SOUTH WAUKESHA ROAD WEST ALLIS, WI 53227 | AFLAC | $45 | $0 | $45 | 0.25% |
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 | 166 | 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) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 87 | $632K |
| Dental | HUMANA INSURANCE COMPANY | 72 | $39K |
| Vision | HUMANA INSURANCE COMPANY | 72 | $39K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 166 | $39K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 95 | $21K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 87 | $632K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 166 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.