| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT SERVICES GROUP, INC.3 Filed as: BENEFIT SERVICES GROUP | N25 W23050 PAUL ROAD PEWAUKEE, WI 53072 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | $255K | — | $255K | 5.91% |
| INGENIUM PRIME INC3 Filed as: INGENIUM PRIME, INC. | N25 W23050 PAUL ROAD PEWAUKEE, WI 530720000 | DELTA DENTAL OF WISCONSIN | $29K | — | $29K | 6.48% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP | N25 W23050 PAUL RD PEWAUKEE, WI 53072 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $13K | — | $13K | 3.36% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: BENEFIT SERVICES GROUP | N25 W23050 PAUL ROAD PEWAUKEE, WI 53072 | SELECTHEALTH | $11K | — | $11K | 3.90% |
| PATRICK J KOHLER3 | 11270 W PARK PLACE-STE 100 MILWAUKEE, WI 53224 | NORTHWESTERN MUTUAL | $9K | $2K | $11K | 4.13% |
| WILLIAM JOHN COLLINS3 | 1036 W JUNEAU AVE-STE 302 MILWAUKEE, WI 53233 | NORTHWESTERN MUTUAL | $7K | $2K | $8K | 3.10% |
| BRIAN P DIX3 | 1036 W JUNEAU AVE. MILWAUKEE, WI 53233 | NORTHWESTERN MUTUAL | $7K | $2K | $8K | 3.10% |
| THE HOLTER AGENCY INC3 Filed as: THE HOLTER AGENCY, INC. | 100 E WISCONSIN AVE-STE 2300 MILWAUKEE, WI 53202 | NORTHWESTERN MUTUAL | $3K | $418 | $4K | 1.48% |
| JAMES P GROGAN3 | 11270 W PARK PLACE-STE 100 MILWAUKEE, WI 53224 | NORTHWESTERN MUTUAL | $872 | $313 | $1K | 0.45% |
| PATRICK J KOHLER3 | 11270 W PARK PLACE-STE 100 MILWAUKEE, WI 53224 | NORTHWESTERN MUTUAL | $8K | $2K | $10K | 4.16% |
| WILLIAM JOHN COLLINS3 | 1036 W JUNEAU AVE-STE 302 MILWAUKEE, WI 53233 | NORTHWESTERN MUTUAL | $6K | $2K | $8K | 3.12% |
| BRIAN P DIX3 | 1036 W JUNEAU AVE-STE 302 MILWAUKEE, WI 53233 | NORTHWESTERN MUTUAL | $6K | $2K | $8K | 3.12% |
| THE HOLTER AGENCY INC3 Filed as: THE HOLTER AGENCY INC. | 100 E WISCONSIN AVE. - STE 2300 MILWAUKEE, WI 53202 | NORTHWESTERN MUTUAL | $3K | $396 | $4K | 1.49% |
| JAMES P GROGAN3 | 11270 W PARK PLACE-STE 100 MILWAUKEE, WI 53224 | NORTHWESTERN MUTUAL | $825 | $296 | $1K | 0.45% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP | PO BOX 78117 MILWAUKEE, WI 53278 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | $8K | — | $8K | 10.00% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC | PO BOX 78117 MILWAUKEE, WI 53278 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $25K | $5K | $29K | 64.16% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE-SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $17 | $17 | 0.04% |
| M BARRINGTON CORPORATION3 Filed as: M BARRINGTON CORP | 1325 W TOWNE SQUARE RD MEQUON, WI 53092 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $14 | $2K | 4.81% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: THE BENEFIT SERVICES GROUP INC | PO BOX 6762 CAROL STREAM, IL 60197 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.56% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS INC. | 1125 NW COUCH STREET-STE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $789 | $789 | 2.16% |
| BENEFIT SERVICES GROUP, INC.3 Filed as: BENEFIT SERVICES GROUP | PO BOX 6762 CAROL STREAM, IL 60197 | CARE-PLUS DENTAL PLANS, INC. | $1K | — | $1K | 5.00% |
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 | 554 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 564 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 707 | $5.0M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 407 | $475K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 419 | $82K |
| Life insurance | NORTHWESTERN MUTUAL | 554 | $264K |
| Long-term disability(2 contracts, 2 carriers) | NORTHWESTERN MUTUAL | 548 | $285K |
| Prescription drug(3 contracts, 3 carriers) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 707 | $5.0M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 222 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 707 | — |
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.