| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TAYLOR ORTON3 | 2323 CROSSROADS DR MADISON, WI 53718 | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | $11K | — | $11K | 2.35% |
| GREGGORY RIEK3 | 800 MAIN ST DUBUQUE, IA 52004 | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | $1K | — | $1K | 0.22% |
| TAYLOR ORTON3 | 2323 CROSSROADS DR MADISON, WI 53718 | WPS HEALTH PLAN, INC. | $7K | — | $7K | 3.14% |
| GREGGORY RIEK3 | 800 MAIN ST DUBUQUE, IA 52004 | WPS HEALTH PLAN, INC. | $700 | — | $700 | 0.30% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SERVICES | 800 MAIN ST DUBUQUE, IA 52001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 6.09% |
| MAYNARD IRVIN HEBERT II3 | 106 CUMBERLYNN DR FOND DU LAC, WI 54935 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $194 | $1K | 5.67% |
| CAMERON SUTTON ROBERTS3 | N9404 ROSELLA DR APPLETON, WI 54915 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $952 | $97 | $1K | 4.49% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWY ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $68 | — | $68 | 0.29% |
| DANIEL FROST3 | 241 POYGAN RD OMRO, WI 54963 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $1 | $19 | 0.08% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INC | PO BOX 28 DUBUQUE, IA 52004 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 12.06% |
| COTTINGHAM & BUTLER3 | 800 MAIN STREET P.O. BOX 28 DUBUQUE, IA 52004 | CARE-PLUS DENTAL PLANS, INC | $1K | — | $1K | 6.00% |
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 | 104 | 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) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | 99 | $696K |
| Dental | CARE-PLUS DENTAL PLANS, INC | 62 | $19K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 105 | $20K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 105 | $20K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 105 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 105 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.