| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN-JOHNSON INS INC | 700 REGENT STREET MADISON, WI 53711 | COMPCARE HEALTH SERVICES INSURANCE COPORATION (G0423) | $0 | — | $0 | 0.00% |
| TRICOR, INC3 Filed as: TRICOR, INC. | 230 W CHERRY STREET LANCASTER, WI 538131629 | UNITED OF OMAHA LIFE INSURANCE COMPANY-2 | $2K | — | $2K | 10.00% |
| TRICOR, INC3 Filed as: TRICOR, INC. | 230 W. CHERRY STREET LANCASTER, WI 538131629 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| TRICOR, INC3 Filed as: TRICOR INC - LANCASTER | PO BOX 450 LANCASTER, WI 538130450 | HUMANADENTAL INSURANCE COMPANY | $423 | — | $423 | 4.90% |
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 | 209 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPCARE HEALTH SERVICES INSURANCE COPORATION (G0423) | 209 | $224K |
| Dental | HUMANADENTAL INSURANCE COMPANY | 146 | $9K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY-2 | 183 | $17K |
| Prescription drug | COMPCARE HEALTH SERVICES INSURANCE COPORATION (G0423) | 209 | $224K |
| Stop-loss / reinsurancereinsurance | COMPCARE HEALTH SERVICES INSURANCE COPORATION (G0423) | 209 | $224K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY-2 | 183 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.