| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SERVICES | 100 N. CORPORATE STE 100 BROOKFIELD, WI 53045 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $68K | $68K | 4.17% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SERVICES | 100 N. CORPORATE DR. STE 100 BROOKFIELD, WI 530455800 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 3.41% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUITIONS IN | 100 N. CORPORATE DR. STE 100 BROOKFIELD, WI 53045 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 7.08% |
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN ST #320 RACINE, WI 53403 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $97 | $97 | 0.26% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS INC | 100 N. CORPORATE DR. STE 100 BROOKFIELD, WI 53045 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 12.20% |
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN ST #320 RACINE, WI 53403 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $72 | $72 | 0.26% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS INC | 100 N. CORPORATE DR. STE 100 BROOKFIELD, WI 53045 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 9.44% |
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN ST #320 RACINE, WI 53403 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $56 | $56 | 0.25% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTION | 100 N CORPORATE DRIVE SUITE 100 BROOKFIELD, WI 53045 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $3K | $3K | 24.89% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFED INSURANCE SOLUTIONS INC | 100 N CORPORATE DR #100 BROOKFIELD, WI 53045 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN ST #320 RACINE, WI 53403 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $36 | $36 | 0.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | — | $8K |
| EMPATHIA, INC. EIN 39-1567366 OTHER SERVICES | Other services Service code 49 | — | $5K |
| DIVERSIFED INSURANCE SOLUTIONS INSURANCE AGENT/BROKER | Insurance agents and brokers Service code 22 | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 53045 | $0 |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 330 | $1.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 296 | $111K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 183 | $14K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 160 | $22K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 159 | $38K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 159 | $28K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 160 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 330 | — |
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."
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.