| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY | 1420 NORTH RIDGE DRIVE PO BOX 40 PRAIRIE DU SAC, WI 53578 | DEAN HEALTH PLAN INC | $12K | — | $12K | 1.95% |
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY | 1420 NORTH RIDGE DRIVE PO BOX 40 PRAIRIE DU SAC, WI 53578 | UNITY HEALTH PLANS INSURANCE CORPORATION | $6K | — | $6K | 1.41% |
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY | 1420 NORTH RIDGE DRIVE PO BOX 40 PRAIRIE DU SAC, WI 53578 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 6.43% |
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY | 1420 NORTH RIDGE DRIVE PO BOX 40 PRAIRIE DU SAC, WI 53578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 11.25% |
| GROUP INSURANCE SERVICES INC3 | 1607 N AURORA RD STE 201 NAPERVILLE, IL 605632786 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 3.75% |
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY | 1420 NORTH RIDGE DRIVE PO BOX 40 PRAIRIE DU SAC, WI 53578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| GROUP INSURANCE SERVICES INC3 | 1607 N AURORA RD STE 201 NAPERVILLE, IL 605632786 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY | 1420 NORTH RIDGE DRIVE PO BOX 40 PRAIRIE DU SAC, WI 53578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 11.25% |
| GROUP INSURANCE SERVICES INC3 | 1607 N AURORA RD STE 201 NAPERVILLE, IL 605632786 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $712 | — | $712 | 3.75% |
| SCHWARZ INSURANCE AGENCY INC Filed as: SCHWARZ INSURANCE AGENCY | 1420 NORTH RIDGE DRIVE PO BOX 40 PRAIRIE DU SAC, WI 53578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| GROUP INSURANCE SERVICES INC3 | 1607 N AURORA RD STE 201 NAPERVILLE, IL 605632786 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $551 | — | $551 | 5.00% |
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY | 1420 NORTH RIDGE DRIVE PO BOX 40 PRAIRIE DU SAC, WI 53578 | SUPERIOR VISION PLAN OF WISCONSIN INC | $496 | — | $496 | 10.22% |
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 | 146 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | DEAN HEALTH PLAN INC | 213 | $632K |
| Dental | DELTA DENTAL OF WISCONSIN | 89 | $74K |
| Vision | SUPERIOR VISION PLAN OF WISCONSIN INC | 54 | $5K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $42K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $19K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $36K |
| Prescription drug | UNITY HEALTH PLANS INSURANCE CORPORATION | 209 | $389K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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."
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.