| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WI INC. | PO BOX 1650 MILWAUKEE, WI 532011650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $738 | $5K | 13.76% |
| FORSITE BENEFIT PARTNERS3 Filed as: FORSITE BENEFIT PARTNERS LLC | 2300 RIVERSIDE DRIVE GREEN BAY, WI 54301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $882 | — | $882 | 2.53% |
| SECURITY PLUS LLC3 | 2308 MINNESOTA AVE STEVENS POINT, WI 54481 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 21.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WI INC. | PO BOX 1650 MILWAUKEE, WI 532011650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $446 | $3K | 13.45% |
| FORSITE BENEFIT PARTNERS3 Filed as: FORSITE BENEFIT PARTNERS LLC | 2300 RIVERSIDE DRIVE GREEN BAY, WI 54301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $487 | — | $487 | 2.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | 400 N EXECUTIVE DR STE. 300 BROOKFIELD, WI 53005 | WYSSTA INSURANCE COMPANY INC. | $2K | — | $2K | 8.07% |
| SECURITY PLUS LLC3 | 2308 MINNESOTA AVE STEVENS POINT, WI 54481 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 22.79% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WI INC. | PO BOX 1650 MILWAUKEE, WI 532011650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $429 | $103 | $532 | 10.31% |
| FORSITE BENEFIT PARTNERS3 Filed as: FORSITE BENEFIT PARTNERS LLC | 2300 RIVERSIDE DRIVE GREEN BAY, WI 54301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $87 | — | $87 | 1.69% |
| DELTAL DENTAL OF WISCONSIN5 | 2801 HOOVER ROAD STEVENS POINT, WI 54481 | DELTA DENTAL OF WISCONSIN | — | $6K | $6K | — |
| FRANK KOPECKY3 | WILLIS OF WISCONSIN, INC. 400 N EXECUTIVE DR, STE 300 BROOKFIELD, WI 53005 | DELTA DENTAL OF WISCONSIN | $381 | — | $381 | — |
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 | 231 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 130 | $0 |
| Vision | WYSSTA INSURANCE COMPANY INC. | 115 | $19K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 364 | $40K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 190 | $20K |
| Other(3 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 364 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 364 | — |
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.