| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TIC INC3 Filed as: TIC INC. | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $22K | $3K | $25K | 17.20% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 2.20% |
| TIC INC Filed as: TIC INC. | 701 SAND LAKE RD ONALASKA, WI 546502442 | DELTA DENTAL OF WISCONSIN | $11K | — | $11K | 9.08% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 546502442 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $21K | — | $21K | 22.24% |
| TIC INC3 Filed as: TIC INC. | 701 SAND LAKE RD ONALASKA, WI 546502442 | DELTA DENTAL OF WISCONSIN | $6K | — | $6K | 9.56% |
| TIC INC3 Filed as: TIC INC. | 701 SAND LAKE RD ONALASKA, WI 546202442 | WYSSTA INSURANCE COMPANY INC | $2K | — | $2K | 8.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLEGIANCE BENEFIT MANAGEMENT, INC. EIN 81-0400550 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $78K |
| ALLEGIANCE CARE MANAGEMENT, INC. EIN 03-0507057 | Contract Administrator; Direct payment from the plan Service code 13 | — | $10K |
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 | 478 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 488 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(3 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 195 | $202K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 418 | $144K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 418 | $240K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 418 | $144K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 418 | $240K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 418 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.