| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AVERGENT LLC3 | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10K | — | $10K | 10.86% |
| EPSIX, INC.3 | 13924 E DYER LN SCOTTSDALE, AZ 85262 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 7.02% |
| MARK HOLZINGER3 Filed as: MARK RANCE PASSI | 3503 MCELROY ST EAU CLAIRE, WI 54701 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 4.30% |
| TAD HOWARD ASP3 | 10890 N SMITH RD HAYWARD, WI 54843 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 1.20% |
| AMY KNUTSON3 Filed as: AMY L KNUTSON | 421 HIGGINS DR EVANSVILLE, WI 53536 | CONTINENTAL AMERICAN INSURANCE COMPANY | $719 | — | $719 | 0.79% |
| NICHOLAS HASELWANDER3 | 101 N. FARWELL STREET, SUITE 203 EAU CLAIRE, WI 54703 | CONTINENTAL AMERICAN INSURANCE COMPANY | $687 | — | $687 | 0.76% |
| MICHAEL FRASIER3 | 1196 DYNES WAY SUN PRAIRIE, WI 53590 | CONTINENTAL AMERICAN INSURANCE COMPANY | $434 | — | $434 | 0.48% |
| KARA SUE STADEL3 | 4049 N RAWLINS RD GALENA, IL 61036 | CONTINENTAL AMERICAN INSURANCE COMPANY | $341 | — | $341 | 0.37% |
| KAREN SUE KIEFER3 | 2517 JACOBS CREEK RUN FORT WAYNE, IN 46825 | CONTINENTAL AMERICAN INSURANCE COMPANY | $205 | — | $205 | 0.23% |
| WILLIAM CHARLES HAGEN3 | 5709 MAPLE CT MCFARLAND, WI 53558 | CONTINENTAL AMERICAN INSURANCE COMPANY | $201 | — | $201 | 0.22% |
| JAMES PRINISKI3 | 1218 N PAGE ST STOUGHTON, WI 53589 | CONTINENTAL AMERICAN INSURANCE COMPANY | $191 | — | $191 | 0.21% |
| PAUL W DESPIRITO3 | N 2892 HILLCREST DR HORTONVILLE, WI 54944 | CONTINENTAL AMERICAN INSURANCE COMPANY | $132 | — | $132 | 0.15% |
| MICHELLE L NODORFT3 | 1546 COUNTY ROAD B PLATTEVILLE, WI 53818 | CONTINENTAL AMERICAN INSURANCE COMPANY | $85 | — | $85 | 0.09% |
| JENNIFER L DAVIES3 | 1712 E LAFAYETTE PL MILWAUKEE, WI 53202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $77 | — | $77 | 0.08% |
| MORGAN E MARKOWSKI3 Filed as: MORGAN ELIZABETH MARKOWSKI | 1616 S 167TH ST NEW BERLIN, WI 53151 | CONTINENTAL AMERICAN INSURANCE COMPANY | $58 | — | $58 | 0.06% |
| CIARA MORRISON3 | 814 PARKVIEW DR MILTON, WI 53563 | CONTINENTAL AMERICAN INSURANCE COMPANY | $53 | — | $53 | 0.06% |
| TARA A STAPELMANN3 | 10353 MIDLAND RD MAZOMANIE, WI 53560 | CONTINENTAL AMERICAN INSURANCE COMPANY | $46 | — | $46 | 0.05% |
| ALEC MICHAEL MANDICH3 | N89W16312 CLEVELAND AVE MENOMONEE FALLS, WI 53051 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27 | — | $27 | 0.03% |
| MANDY RUECHEL3 | 1030 LUM AVE WATERLOO, WI 53594 | CONTINENTAL AMERICAN INSURANCE COMPANY | $20 | — | $20 | 0.02% |
| AVERGENT LLC3 | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 6.76% |
| AVERGENT LLC3 | 112 PACKERLAND DR GREEN BAY, WI 54303 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $3K | — | $3K | 11.74% |
| AVERGENT LLC3 | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 16.00% |
| AVERGENT LLC3 | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $235 | — | $235 | 10.00% |
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 | 319 | 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) | 319 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 309 | $25K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 213 | $2K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 212 | $65K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 210 | $28K |
| Other(3 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 213 | $116K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 309 | — |
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.