| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LISA ANN SCAMEHORN3 | 2600 EAGAN WOODS DR SUITE 140 EAGAN, MN 55121 | NORTHWESTERN MUTUAL | $5K | $1K | $6K | 2.20% |
| STEVEN HELLING3 Filed as: STEVEN ALBERT HELLING | 101 MAIN STREET CLAYTON, WI 54004 | NORTHWESTERN MUTUAL | $2K | $499 | $2K | 0.94% |
| HELLYER GROUP LLC3 | 1191 NORTHLAND DR SUITE 150 MENDOTA HTS, MN 55120 | NORTHWESTERN MUTUAL | $1K | $134 | $1K | 0.48% |
| BRENT GOSKA3 Filed as: BRENT STANLEY GOSKA | 1450 RIVERS EDGE TRL SUITE B ALTOONA, WI 54720 | NORTHWESTERN MUTUAL | $198 | $71 | $269 | 0.10% |
| LISA ANN SCAMEHORN3 | 2600 EAGAN WOODS DR. SUITE 140 EAGAN, MN 55121 | NORTHWESTERN MUTUAL | $4K | $1K | $6K | 5.45% |
| STEVEN HELLING3 Filed as: STEVEN ALBERT HELLIN | 101 MAIN STREET CLAYTON, WI 54004 | NORTHWESTERN MUTUAL | $2K | $476 | $2K | 2.33% |
| HELLYER GROUP LLC3 | 1191 NORTHLAND DR. SUITE 150 MENDOTA HITS, MN 55120 | NORTHWESTERN MUTUAL | $1K | $128 | $1K | 1.18% |
| BRENT GOSKA3 Filed as: BRENT STANLEY GOSKA | 1450 RIVERS EDGE TR SUITE B ALTOONA, WI 54720 | NORTHWESTERN MUTUAL | $189 | $68 | $257 | 0.25% |
| PHAROS EMPLOYEE BENEFITS INC3 Filed as: PHAROS EMPLOYEE BENEFITS INC. | 2600 EAGAN WOODS DR. SUITE 140 EAGAN, MN 55121 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $1K | $9K | 17.95% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR. SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $809 | $809 | 1.68% |
| PHAROS EMPLOYEE BENEFITS INC3 Filed as: PHAROS EMPLOYEE BENEFITS INC. | 2600 EAGAN WOODS DR. SUITE 140 EAGAN, MN 55121 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $971 | $4K | 13.19% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR. SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $555 | $555 | 1.82% |
| LISA ANN SCAMEHORN3 | 2600 EAGAN WOODS DR SUITE 140 EAGAN, MN 55121 | NORTHWESTERN MUTUAL | $2K | $418 | $2K | 6.91% |
| STEVEN HELLING3 Filed as: STEVEN ALBERT HELLING | 101 MAIN STREET CLAYTON, WI 54004 | NORTHWESTERN MUTUAL | $710 | $179 | $889 | 2.96% |
| HELLYER GROUP LLC3 | 1191 NORTHLAND DR SUITE 150 MENDOTA HTS, MN 55120 | NORTHWESTERN MUTUAL | $402 | $48 | $450 | 1.50% |
| BRENT GOSKA3 Filed as: BRENT STANLEY GOSKA | 1450 RIVERS EDGE TR SUITE B ALTOONA, WI 54720 | NORTHWESTERN MUTUAL | $71 | $25 | $96 | 0.32% |
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 | 449 | 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) | 449 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 224 | $30K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 448 | $78K |
| Short-term disability | NORTHWESTERN MUTUAL | 448 | $263K |
| Long-term disability | NORTHWESTERN MUTUAL | 448 | $101K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 251 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 448 | — |
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.