| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITSPRO INC.3 Filed as: BENEFITSPRO INC | W6845 SOUTH SHORE DRIVE DELAVAN, WI 53115 | BLUE CROSS OF CALIFORNIA | $44K | — | $44K | 4.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMINISTRATO | 721 SOUTH PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | — | $18K | $18K | 1.99% |
| JERRY W VAN NESS3 | 529 FREE CHURCH DRIVE WILLIAMS BAY, WI 53191 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $13K | — | $13K | 5.64% |
| JERRY W VAN NESS3 | 529 FREE CHURCH DRIVE WILLIAMS BAY, WI 53191 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $6K | — | $6K | 5.60% |
| BENEFITSPRO INC.3 Filed as: BENEFITSPRO INC | W6845 SOUTH SHORE DRIVE DELAVAN, WI 53115 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | — | $9K | 9.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS ADMIN | 721 SOUTH PARKER STREET SUITE 200 ORANGE, CA 92868 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 5.03% |
| JERRY W VAN NESS3 | 529 FREE CHURCH DRIVE WILLIAMS BAY, WI 53191 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $2K | — | $2K | 5.03% |
| JERRY WILLIAMS VAN NESS3 | 11 NORTH COLUMBIA STREET NAPERVILLE, IL 60540 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 9.76% |
| ENROLLEASE3 | 660 YORK STREET SUITE 102 SAN FRANCISCO, CA 94110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $831 | — | $831 | 2.21% |
| BRANDON PENKO3 | 4927 MAGNOLIA BEND DRIVE ROSHARON, TX 77583 | TRUSTMARK INSURANCE COMPANY | $806 | — | $806 | 8.65% |
| BENEFITSPRO INC.3 | 529 FREE CHURCH DRIVE WILLIAMS BAY, WI 53191 | TRUSTMARK INSURANCE COMPANY | $528 | — | $528 | 5.66% |
| BRANDON PENKO3 | 4927 MAGNOLIA BEND DRIVE ROSHARON, TX 77583 | TRUSTMARK INSURANCE COMPANY | $639 | — | $639 | 6.89% |
| BENEFITSPRO INC.3 | 529 FREE CHURCH DRIVE WILLIAMS BAY, WI 53191 | TRUSTMARK INSURANCE COMPANY | $637 | — | $637 | 6.87% |
| BRANDON PENKO3 | 4927 MAGNOLIA BEND DRIVE ROSHARON, TX 77583 | TRUSTMARK INSURANCE COMPANY | $1K | — | $1K | 11.98% |
| BENEFITSPRO INC.3 | 529 FREE CHURCH DRIVE WILLIAMS BAY, WI 53191 | TRUSTMARK INSURANCE COMPANY | $684 | — | $684 | 7.78% |
| BENEFITSPRO INC.3 | 529 FREE CHURCH DRIVE WILLIAMS BAY, WI 53191 | TRUSTMARK INSURANCE COMPANY | $465 | — | $465 | 9.92% |
| BRANDON PENKO3 | 4927 MAGNOLIA BEND DRIVE ROSHARON, TX 77583 | TRUSTMARK INSURANCE COMPANY | $415 | — | $415 | 8.85% |
| BENEFITSPRO INC.3 Filed as: BENEFITSPRO INC | W6845 SOUTH SHORE DRIVE DELAVAN, WI 53115 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $372 | — | $372 | 10.15% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS ADMIN | 721 SOUTH PARKER STREET SUITE 200 ORANGE, CA 92868 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $186 | — | $186 | 5.07% |
| JERRY W VAN NESS3 Filed as: JERRY VAN NESS | 529 FREE CHURCH DRIVE WILLIAMS BAY, WI 53191 | LANDMARK HEALTHPLAN | $234 | — | $234 | 10.00% |
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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 43 | $1.3M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 226 | $97K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 226 | $93K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 143 | $47K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 143 | $38K |
| Other(6 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 143 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.