| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R & R INSURANCE SERVICES INC3 | N14W23900 STONE RIDGE DR WAUKESHA, WI 53188 | UNITED OF OMAHA INSURANCE COMPANY | $3K | $6K | $9K | 8.32% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER | INSURANCE SER 800 MAIN ST DUBUQUE, IA 52001 | UNITED OF OMAHA INSURANCE COMPANY | $1K | — | $1K | 1.25% |
| R & R INSURANCE SERVICES INC3 Filed as: R & R INSURANCE SERVICES | N14 W23900 STONE RIDGE DRIVE WAUKESHA, WI 53188 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $2K | — | $2K | 8.28% |
| COTTINGHAM & BUTLER3 | 800 MAIN STREET DUBUQUE, IA 520040028 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $166 | — | $166 | 0.83% |
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 | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 218 | $20K |
| Life insurance | UNITED OF OMAHA INSURANCE COMPANY | 151 | $102K |
| Short-term disability | UNITED OF OMAHA INSURANCE COMPANY | 151 | $102K |
| Long-term disability | UNITED OF OMAHA INSURANCE COMPANY | 151 | $102K |
| Other | UNITED OF OMAHA INSURANCE COMPANY | 151 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 218 | — |
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.