| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 14.92% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $967 | $967 | 2.79% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 11.55% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 19.42% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $853 | $853 | 3.53% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $5K | 21.42% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $729 | $729 | 3.21% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SERVICES INC | 100 NORTH CORPORATE DRIVE STE 100 BROOKFIELD, WI 53045 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 9.33% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $673 | $385 | $1K | 15.73% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $193 | $193 | 2.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | — | $8K |
| DIVERSIFIED BENEFIT SERVICES CLAIMS ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 625 WALNUT RIDGE DR # 190 HARTLAND, WI 53029 | $6K |
| ASSOCIATED BENEFITS & RISK CON INSURANCE AGENT OR BROKE | Insurance agents and brokers Service code 22 | 711 EISENHOWER DR KIMBERLY, WI 54136 | $3K |
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORAT | 121 | $1.2M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 103 | $13K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $29K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $35K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 43 | $24K |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 209 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.
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.