| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WI BANKERS ASSOC EMPLOYEE BNFT3 Filed as: WI BANKERS ASSOC EMPLOYEE BNFT CORP | PO BOX 8880 MADISON, WI 53708 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $87K | — | $87K | 8.14% |
| TAYLOR ORTON3 | COTTINGHAM AND BUTLER INSURANCE SER 800 MAIN ST DUBUQUE, IA 52001 | PREVEA360 HEALTH PLAN | $16K | — | $16K | 1.59% |
| W B A-EMPLOYEE BENEFITS CORP3 Filed as: W B A - EMPLOYEE BENEFITS CORP | 4721 S BILTMORE LN MADISON, WI 53718 | DELTA DENTAL OF WISCONSIN | $6K | — | $6K | 4.74% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER | INSURANCE SERVICES INC. 800 MAIN STREET DUBUQUE, IA 52001 | ANTHEM LIFE INSURANCE COMPANY | $2K | — | $2K | 7.23% |
| VAN DRISSE INSURANCE AGENCY3 Filed as: VAN DRISSE INSURANCE AGENCY INC | PO BOX 100 LUXEMBURG, WI 54217 | ANTHEM LIFE INSURANCE COMPANY | $861 | — | $861 | 3.79% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH STREET SUITE 234 PHOENIX, AZ 85018 | ANTHEM LIFE INSURANCE COMPANY | — | $158 | $158 | 0.69% |
| WBA EMPLOYEE BENEFITS CORP3 Filed as: WBA - EMPLOYEE BENEFIT CORP | 4721 S. BILTMORE LANE MADISON, WI 53718 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $1K | — | $1K | 7.43% |
| HUGUET JOHN3 Filed as: HUGUET JOHN M | 1239 GRIGNON GREEN BAY, WI 54301 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $468 | — | $468 | 8.05% |
| FIRST SERVICES INS3 | C/O JOHN HUGUET 1239 GRIGNON ST GREEN BAY, WI 54301 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $204 | — | $204 | 3.51% |
| HUGUET JOHN3 | C/O JOHN HUGUET 1239 GRIGNON ST GREEN BAY, WI 54301 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $131 | — | $131 | 2.25% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $36 | — | $36 | 0.62% |
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 | 108 | 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) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREVEA360 HEALTH PLAN | 238 | $1.0M |
| Dental | DELTA DENTAL OF WISCONSIN | 95 | $116K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 94 | $16K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 0 | $1.1M |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 96 | $23K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 0 | $1.1M |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 101 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 238 | — |
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.
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.