| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 53045 | HUMANA HEALTH PLAN INC | $168K | $4K | $173K | 28.36% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 530455800 | HUMANA DENTAL INSURANCE COMPANY | $8K | $1K | $10K | 3.75% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 530545800 | HUMANA INSURANCE COMPANY | $4K | $321 | $5K | 10.69% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SERVICES INC | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 53045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $136 | $3K | 48.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HUMANA HEALTH PLAN INC EIN 61-1013183 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $325K |
| TASC EIN 39-1561025 NONE | Contract Administrator Service code 13 | 2302 INTERNATIONAL LANE MADISON, WI 53704 | $26K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 ADMINISTRATOR | Contract Administrator Service code 13 | — | $2K |
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 | 428 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 428 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA DENTAL INSURANCE COMPANY | 428 | $255K |
| Vision | HUMANA INSURANCE COMPANY | 319 | $44K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $6K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $6K |
| Stop-loss / reinsurancereinsurance | HUMANA HEALTH PLAN INC | 404 | $609K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 428 | — |
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.