| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS INC | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 53045 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $389 | $389 | 1.04% |
| UNITED BENEFITS ADVISORS INC3 Filed as: UNITED BENEFITS ADVISORS INC. | 10 WUNSHINE LN RED LION, PA 17356 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $70 | $70 | 0.19% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS INC | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 53045 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $323 | $323 | 1.08% |
| UNITED BENEFITS ADVISORS INC3 | 10 WUNSHINE LN RED LION, PA 17356 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $58 | $58 | 0.19% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS INC | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 53045 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $282 | $282 | 1.19% |
| UNITED BENEFITS ADVISORS INC3 Filed as: UNITED BENEFITS ADVISORS, INC | 10 WUNSHINE LN RED LION, PA 17356 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $51 | $51 | 0.22% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS | 100 NORTH CORPORATE DRIVE SUITE 100 BROOKFIELD, WI 53045 | SUPERIOR VISION INSURANCE PLAN OF WISONSIN, INC. | $1K | — | $1K | 11.12% |
| R & R INSURANCE SERVICES INC3 | 1518 E RACINE AVE WAUKESHA, WI 53186 | SUPERIOR VISION INSURANCE PLAN OF WISONSIN, INC. | $215 | — | $215 | 2.10% |
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 | 132 | 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) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISONSIN, INC. | 114 | $10K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 132 | $24K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 132 | $37K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 132 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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.