| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFIT GROUP LLC. | 80 SOUTH 8TH STREET SUITE #700 MINNEAPOLIS, MN 55402 | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $2K | — | $2K | 0.13% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE | 800 MAIN ST PO BOX 28 DUBUQUE, IA 520040028 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $2K | $22K | 10.18% |
| COTTINGHAM & BUTLER3 | 300 SECURITY BLDG DUBUQUE, IA 52001 | WYSSTA INSURANCE COMPANY INC. | $1K | — | $1K | 8.11% |
| LTCI PARTNERS LLC3 Filed as: LTCI PARTNERS | 2924 MARKETPLACE DR MADISON, WI 53719 | LIFESECURE INSURANCE COMPANY | $187 | — | $187 | 7.03% |
| ADAM H MICHAELS3 Filed as: ADAM RUDER | 1034 N ASHLAND AVE CHICAGO, IL 60622 | LIFESECURE INSURANCE COMPANY | $112 | — | $112 | 4.21% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | LIFESECURE INSURANCE COMPANY | $74 | — | $74 | 2.78% |
| JERRY MANNING3 | 1034 N ASHLAND AVE CHICAGO, IL 60622 | LIFESECURE INSURANCE COMPANY | $41 | — | $41 | 1.54% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER SERVICES INC | 10 TERRACE COURT STE 204 MADISON, WI 53718 | AXIS INSURANCE COMPANY | $158 | — | $158 | 14.96% |
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 | 493 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 498 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | 680 | $5.4M |
| Vision | WYSSTA INSURANCE COMPANY INC. | 74 | $15K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 493 | $219K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 493 | $219K |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 493 | $230K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 680 | — |
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 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.