| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANSAY & ASSOCIATES LLC3 | 101 E GRAND AVE #11 PORT WASHINGTON, WI 530742241 | METROPOLITAN LIFE INSURANCE COMPANY | — | $12 | $12 | 0.01% |
| ANSAY & ASSOCIATES LLC3 | 101 E GRAND AVE SUITE 11 PORT WASHINGTON, WI 53074 | METROPOLITAN GENERAL INSURANCE COMPANY | $193 | — | $193 | 8.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTYADMINISTRATOR | Contract Administrator Service code 13 | — | $17K |
| DIVERSIFIED BENEFIT SERVICES CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | 625 WALNUT RIDGE DR # 190 HARTLAND, WI 53029 | $15K |
| ANSAY & ASSOCIATES BROKER | Insurance agents and brokers Service code 22 | 9809 S FRANKLIN DR STE 300 FRANKLIN, WI 53132 | $214 |
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 | 241 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 243 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORP | 241 | $4.3M |
| Vision | HUMANA INSURANCE COMPANY | 265 | $43K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 369 | $130K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 369 | $130K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 369 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 369 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.