| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR MT PLEASANT, WI 53406 | NETWORK HEALTH PLAN | $28K | — | $28K | 3.58% |
| BOONE-CHAPMAN BENEFIT ADMINISTRATOR3 Filed as: BOONE CHAPMAN BENEFIT ADMINISTRATOR | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $2K | $11K | 25.01% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | — | $764 | $764 | 1.77% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR STE 100 MOUNT PLEASANT, WI 534064040 | METROPOLITAN LIFE INSURANCE COMPANY | — | $14 | $14 | 0.03% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES | 1103 HUNTER DR MOUNT PLEASANT, WI 53406 | WYSSTA INSURANCE COMPANY INC | $930 | — | $930 | 8.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMIN | Contract Administrator Service code 13 | — | $5K |
| JOHNSON INSURANCE SERVICES LLC BROKER | Insurance agents and brokers Service code 22 | 1103 HUNTER DR MOUNT PLEASANT, WI 53406 | $4K |
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NETWORK HEALTH PLAN | 92 | $793K |
| Vision | WYSSTA INSURANCE COMPANY INC | 75 | $12K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 131 | $43K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 131 | $43K |
| Other(2 contracts, 2 carriers) | NETWORK HEALTH PLAN | 131 | $836K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 131 | — |
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.