| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCCLONE AGENCY INC3 Filed as: MCCLONE INSURANCE AGENCY | 150 MAIN STREET, SUITE 300 MENASHA, WI 549520389 | HUMANA HEALTH PLAN, INC. | $46K | — | $46K | 10.52% |
| MCCLONE AGENCY INC3 | 150 MAIN STREET, SUITE 300 MENASHA, WI 549523386 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 7.23% |
| MCCLONE AGENCY INC3 | 150 MAIN STREET SUITE 300 MENASHA, WI 549523386 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 13.05% |
| MCCLONE AGENCY INC3 | 150 MAIN STREET, SUITE 300 MENASHA, WI 549520389 | ALLSTATE BENEFITS | $27K | — | $27K | 62.83% |
| MCCLONE AGENCY INC3 | 150 MAIN STREET, SUITE 300 MENASHA, WI 549523386 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | $1K | — | $1K | 10.00% |
| MCCLONE AGENCY INC3 | 150 MAIN STREET, SUITE 300 MENASHA, WI 549523386 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $542 | — | $542 | 10.01% |
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 | 179 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA HEALTH PLAN, INC. | 139 | $433K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | 202 | $13K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 176 | $50K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 176 | $58K |
| Prescription drug | HUMANA HEALTH PLAN, INC. | 139 | $433K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 176 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 202 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.