| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | P.O. BOX 389 MENASHA, WI 54952 | DELTA DENTAL OF WISCONSIN | $5K | $0 | $5K | 6.33% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | P.O. BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.90% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC -MIDWEST | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $866 | $0 | $866 | 4.10% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | P.O. BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.04% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC -MIDWEST | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $831 | $0 | $831 | 4.96% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | P.O. BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 13.07% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC -MIDWEST | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $942 | $0 | $942 | 6.93% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | P.O. BOX 389 MENASHA, WI 54952 | WYSSTA INSURANCE COMPANY INC. | $354 | $0 | $354 | 4.74% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC -WI | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | WYSSTA INSURANCE COMPANY INC. | $195 | $0 | $195 | 2.61% |
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 | 110 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 200 | $1.3M |
| Dental | DELTA DENTAL OF WISCONSIN | 73 | $81K |
| Vision | WYSSTA INSURANCE COMPANY INC. | 70 | $7K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $21K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $17K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 52 | $14K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.