| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LISA A PERRI3 Filed as: LISA SCAMEHORN | 2600 EAGAN WOODS DR STE 40 EAGAN, MN 55121 | THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY | $3K | $752 | $4K | 2.75% |
| STEVEN HELLING3 | 901 W CLAYTON AVE APT B CLAYTON, WI 54004 | THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY | $1K | $322 | $2K | 1.18% |
| HELLYER GROUP LLC3 | 1191 NORTHLAND DR STE 150 MENDOTA HTS, MN 55120 | THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY | $730 | $88 | $818 | 0.60% |
| BRENT GOSKA3 | 1450 RIVERS EDGE TRL STE B ALTOOONA, WI 54720 | THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY | $129 | $46 | $175 | 0.13% |
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 | 287 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 287 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY | 287 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.