| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $3K | $14K | 19.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.95% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | UNITEDHEALTHCARE INSURANCE COMPANY | $10K | $0 | $10K | 14.71% |
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 54952 | UNITEDHEALTHCARE INSURANCE COMPANY | $7K | $0 | $7K | 10.29% |
| LOCKTON COMPANIES, LLC3 | P.O. BOX 843844 KANSAS CITY, MO 64184 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $3K | $0 | $3K | 5.26% |
| MCCLONE AGENCY INC3 | 150 MAIN STREET MENASHA, WI 54952 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $2K | $0 | $2K | 3.75% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CARE-PLUS DENTAL PLANS, INC. | $2K | $0 | $2K | 3.32% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE INSURANCE COMPANY | 150 MAIN STREET SUITE 300 MENASHA, WI 54952 | CARE-PLUS DENTAL PLANS, INC. | $1K | $0 | $1K | 2.68% |
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $2K | $8K | 18.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $731 | $731 | 1.65% |
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $940 | $4K | 19.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $418 | $418 | 1.81% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH STE 900 KANSAS CITY, MO 64112 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $424 | $0 | $424 | 12.52% |
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 54952 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $62 | $0 | $62 | 1.83% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INC SVCS INC | PO BOX 28 DUBUQUE, IA 52004 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $54 | $0 | $54 | 1.59% |
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 | 734 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 738 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CARE-PLUS DENTAL PLANS, INC. | 187 | $46K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 519 | $56K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 442 | $23K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 420 | $44K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 442 | $169K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 519 | — |
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.