| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES INC | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 6.01% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.04% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $2K | — | $2K | 5.84% |
| VALUE ADDED SOLUTIONS3 | 1161 HERITAGE COURT SUN PRAIRIE, WI 53590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $3K | $5K | 15.25% |
| R & R INSURANCE SERVICES INC3 Filed as: R AND R INSURANCE SERVICES, INC. | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $168 | $3K | 9.57% |
| JODY ANN WALL3 | 1334 ROCKRIDGE ROAD APT. 331 WAUKESHA, WI 53188 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $30 | $1K | 3.50% |
| CORCORAN & HOYT LLC3 Filed as: CORCORAN AND HOYT, LLC | 3905 TAMPA ROAD OLDSMAR, FL 34677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $665 | $244 | $909 | 2.79% |
| MARK HOLZINGER3 | 118 EAST HAMILTON AVENUE EAU CLAIRE, WI 54701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $845 | — | $845 | 2.59% |
| MAGGY SUE LOKKEN3 | 18649 53RD AVENUE CHIPPEWA FALLS, WI 54729 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $352 | — | $352 | 1.08% |
| ERICK TAVAREZ3 | 212 SPRINGVIEW DRIVE MARSHALL, WI 53559 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | $50 | $134 | 0.41% |
| MARY R ROEMER3 | N16 W26577 WILD OATS DR. UNIT E PEWAUKEE, WI 53072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | $23 | $84 | 0.26% |
| PATRICK VICTOR SLATTERY3 | 2066 PLUM ROAD RUDOLPH, WI 55475 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $83 | — | $83 | 0.25% |
| TRACY TSCHANZ3 Filed as: TRACY M VERHAALEN | 14085 SOLITAIRE CT NEW BERLIN, WI 53151 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $80 | — | $80 | 0.25% |
| JAMES CALLAHAN3 | 312 MONTEREY DRIVE BOLINGBROOK, IL 60440 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | — | $60 | 0.18% |
| COMMUNICATION GUILD LLC3 | 154 N PARK BLVD GLEN ELLYN, IA 60137 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $44 | $59 | 0.18% |
| GERALD A GREENEN3 Filed as: GERALD A GREENAN | 472 ROUTE 47 STE F-102 SUGAR GROVE, IL 60554 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $9 | $24 | 0.07% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $1K | — | $1K | 6.32% |
| R & R INSURANCE SERVICES INC3 Filed as: R AND R INSURANCE SERVICES, INC. | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | WYSSTA INSURANCE COMPANY INC. | $776 | — | $776 | 5.44% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLAN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC. | $349 | — | $349 | 2.45% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES INC | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $557 | $572 | $1K | 11.93% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $389 | — | $389 | 4.11% |
| R & R INSURANCE SERVICES INC3 Filed as: R AND R INSURANCE SERVICES, INC. | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | UNITED OF OMAHA LIFE INSURACE COMPANY | $542 | $368 | $910 | 14.55% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLAN DRIVE MADISON, WI 53713 | UNITED OF OMAHA LIFE INSURACE COMPANY | $396 | — | $396 | 6.33% |
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 | 135 | 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) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF WISCONSIN | 50 | $56K |
| Vision | WYSSTA INSURANCE COMPANY INC. | 89 | $14K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $9K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $49K |
| Long-term disability | UNITED OF OMAHA LIFE INSURACE COMPANY | 33 | $6K |
| Other(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 137 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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.