| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS | 100 N CORPORATE DRIVE SUITE 100 BROOKFIELD, WI 53045 | UNITED HEALTHCARE INSURANCE COMPANY | $37K | — | $37K | 10.01% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS | 100 N CORPORATE DRIVE SUITE 100 BROOKFIELD, WI 53045 | DELTA DENTAL OF WISCONSIN | $3K | — | $3K | 5.47% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS | 100 N CORPORATE DRIVE SUITE 100 BROOKFIELD, WI 53045 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 5.36% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS | 100 N CORPORATE DRIVE SUITE 100 BROOKFIELD, WI 53045 | DELTA DENTAL OF WISCONSIN | $2K | — | $2K | 5.61% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS | 100 N CORPORATE DRIVE SUITE 100 BROOKFIELD, WI 53045 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 13.15% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS | 100 N CORPORATE DRIVE SUITE 100 BROOKFIELD, WI 53045 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.79% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $95K |
| DIVERSIFIED INSURANCE SOLUTIONS EIN 39-1403176 BROKER | Other commissions Service code 55 | 100 N. CORPORATE DR STE 100 BROOKFIELD, WI 53045 | $5K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 BROKER | Other commissions Service code 55 | — | $5K |
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 | 174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF WISCONSIN | 76 | $99K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 169 | $15K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 169 | $56K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 169 | $24K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 154 | $371K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 169 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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.