| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: BENEFIT ALLIANT LLC | P.O. BOX 11267 MILWAUKEE, WI 53211 | BLUE CROSS BLUE SHIELD OF WISCONSIN & COMPCARE HEALTH SRVCS INS CORP | $44K | $4K | $48K | 3.00% |
| AVERGENT LLC3 | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | BLUE CROSS BLUE SHIELD OF WISCONSIN & COMPCARE HEALTH SRVCS INS CORP | $9K | — | $9K | 0.55% |
| VIZANCE, INC.3 | 1320 WALNUT RIDGE DRIVE SUITE 200 HARTLAND, WI 53029 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $3K | $6K | 11.76% |
| AVERGENT LLC3 Filed as: AVERGENT, LLC | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $809 | — | $809 | 1.48% |
| AVERGENT LLC3 Filed as: AVERGENT | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | DELTA DENTAL OF WISCONSIN | $3K | — | $3K | 8.01% |
| VIZANCE, INC.3 Filed as: VIZANCE | 1320 WALNUT RIDGE DRIVE SUITE 200 HARTLAND, WI 53029 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $4K | 17.14% |
| AVERGENT LLC3 Filed as: AVERGENT, LLC | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 5.35% |
| VIZANCE, INC.3 Filed as: VIZANCE | 1320 WALNUT RIDGE DR STE 200 HARTLAND, WI 53029 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.23% |
| VIZANCE, INC.3 Filed as: VIZANCE | 1320 WALNUT RIDGE DRIVE SUITE 200 HARTLAND, WI 53029 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $135 | $121 | $256 | 12.51% |
| AVERGENT LLC3 Filed as: AVERGENT, LLC | 1400 LOMBARDI AVE STE 40 GREEN BAY, WI 54304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $70 | — | $70 | 3.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMIN | Contract Administrator Service code 13 | 2801 HOOVER ROAD STEVENS POINT, WI 54481 | $10K |
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 | 201 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF WISCONSIN & COMPCARE HEALTH SRVCS INS CORP | 322 | $1.6M |
| Dental | DELTA DENTAL OF WISCONSIN | 54 | $36K |
| Vision | BLUE CROSS BLUE SHIELD OF WISCONSIN & COMPCARE HEALTH SRVCS INS CORP | 322 | $1.6M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 199 | $28K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 198 | $55K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 198 | $22K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF WISCONSIN & COMPCARE HEALTH SRVCS INS CORP | 322 | $1.6M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 199 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 322 | — |
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."
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.