| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS GROUP INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | MEDICA INSURANCE COMPANY | — | $3K | $3K | 0.20% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $16K | — | $16K | 6.70% |
| COTTINGHAM & BUTLER3 | 300 SECURITY BLDG DUBUQUE, IA 52001 | WYSSTA INSURANCE COMPANY INC. | $1K | — | $1K | 8.03% |
| LTCI PARTNERS LLC3 Filed as: LTCI PARTNERS | 2924 MARKETPLACE DR MADISON, WI 53719 | LIFESECURE INSURANCE COMPANY | $153 | — | $153 | 7.32% |
| ADAM H MICHAELS3 Filed as: ADAM RUDER | 1034 N ASHLAND AVE CHICAGO, IL 60622 | LIFESECURE INSURANCE COMPANY | $79 | — | $79 | 3.78% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | LIFESECURE INSURANCE COMPANY | $52 | — | $52 | 2.49% |
| JERRY MANNING3 | 1034 N ASHLAND AVE CHICAGO, IL 60622 | LIFESECURE INSURANCE COMPANY | $29 | — | $29 | 1.39% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER SERVICES INC | 10 TERRACE COURT STE 204 MADISON, WI 53718 | AXIS INSURANCE COMPANY | $225 | — | $225 | 15.00% |
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 | 512 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 521 | 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 | 284 | $5.6M |
| Vision | WYSSTA INSURANCE COMPANY INC. | 112 | $16K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 489 | $232K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 489 | $232K |
| Other(4 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 552 | $243K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 552 | — |
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.