| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | NETWORK HEALTH PLAN | $4K | — | $4K | 0.07% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC | PO BOX 389 MENASHA, WI 54952 | NETWORK HEALTH PLAN | $2K | $959 | $3K | 0.05% |
| USI INSURANCE SERVICES LLC | 711 EISENHOWSER DR KIMBERLY, WI 54136 | SUNLIFE ASSURANCE COMPANY OF CANADA | $0 | — | $0 | 0.00% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWSER DR KIMBERLY, WI 54136 | STANDARD INSURANCE COMPANY | $8K | $0 | $8K | 4.18% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY | PO BOX 389 MENASHA, WI 54952 | STANDARD INSURANCE COMPANY | $3K | $2K | $5K | 2.87% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY | PO BOX 389 MENASHA, WI 54952 | STANDARD INSURANCE COMPANY | $5K | $1K | $6K | 3.37% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 0.67% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 6.60% |
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 54952 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.54% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GROUP | 711 EISENHOWER DR KIMBERLY, WI 54136 | CARE PLUS DENTAL PLANS | $6K | — | $6K | 6.00% |
| USI INSURANCE SERVICES LLC Filed as: USI LLC. - WI ABRC | 711 EISENHOWER DR KIMBERLY, WI 54136 | SUPERIOR VISION PLAN | $6K | — | $6K | 6.74% |
| MCCLONE AGENCY INC | 150 MAIN STREET SUITE 300 MENASHA, WI 54952 | SUPERIOR VISION PLAN | $3K | — | $3K | 3.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUCENT HEALTH SOLUTIONS LLC EIN 39-1997579 TPA | Claims processing Service code 12 | 5560 W GRANDE MARKET DR APPLETON, WI 54913 | $65K |
| CAPFINANCIAL PARTNERS, LLC EIN 26-0058143 CONSULTANT | Consulting fees Service code 70 | 4208 SIX FORKS RD SUITE 1700 RALEIGH, NC 27609 | $55K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 TPA | Contract Administrator Service code 13 | 2801 HOOVER RD PO BOX 828 STEVENS POINT, WI 54481 | $23K |
| USI INSURANCE SERVICES | Custodial (securities) Service code 19 | — | $19K |
| ASSOCIATED FINANCIAL GROUP | Custodial (securities) Service code 19 | — | $18K |
| MCCLONE INSURANCE GROUP | Custodial (securities) Service code 19 | — | $17K |
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 | 841 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 866 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NETWORK HEALTH PLAN | 519 | $6.3M |
| Dental | CARE PLUS DENTAL PLANS | 278 | $94K |
| Vision | SUPERIOR VISION PLAN | 403 | $82K |
| Life insurance(3 contracts, 3 carriers) | SUNLIFE ASSURANCE COMPANY OF CANADA | 1,098 | $760K |
| Long-term disability | STANDARD INSURANCE COMPANY | 838 | $187K |
| Prescription drug | NETWORK HEALTH PLAN | 519 | $6.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,098 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.