| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRICOR, INC3 Filed as: TRICOR INSURANCE | 724 E MAIN STREET STOUGHTON, WI 53589 | DEAN HEALTH PLAN, INC | $12K | — | $12K | 0.59% |
| TRICOR, INC3 Filed as: TRICOR INSURANCE | 2001 W BELTLINE HWY, STE 201 MADISON, WI 53713 | PHYSICIANS PLUS INSURANCE CORP | $15K | $750 | $16K | 1.56% |
| TRICOR, INC3 Filed as: TRICOR INSURANCE AGENCY | 230 W CHERRY ST LANCASTER, WI 538130000 | DELTA DENTAL OF WISCONSIN | $9K | — | $9K | 4.87% |
| TRICOR, INC3 | 230 W CHERRY ST LANCASTER, WI 538131629 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $8K | 6.93% |
| TRICOR, INC3 | 230 W CHERRY ST LANCASTER, WI 538131629 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $1K | $7K | 14.92% |
| TRICOR, INC3 | 230 W CHERRY ST LANCASTER, WI 538131629 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $575 | $4K | 14.10% |
| TRICOR, INC3 | 230 W CHERRY ST LANCASTER, WI 538131629 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $615 | $3K | 12.28% |
| TRICOR, INC3 | 230 W CHERRY ST LANCASTER, WI 538131629 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $295 | $40 | $335 | 17.04% |
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 | 268 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | DEAN HEALTH PLAN, INC | 296 | $3.0M |
| Dental | DELTA DENTAL OF WISCONSIN | 222 | $186K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 347 | $76K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 270 | $109K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 148 | $30K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 347 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 347 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.