| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIASTAR LIFE INSURANCE COMPANY | $16K | — | $16K | 7.47% |
| SCOT J MADSON3 Filed as: SCOT J. MADSON | 11 NORTH WASHINGTON STREET GREEN BAY, WI 54301 | BERKSHIRE LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 6.96% |
| THIRD COAST ADVISORS INC3 Filed as: THIRD COAST ADVISORS, INC. | 1166 QUAIL COURT, SUITE 100 PEWAUKEE, WI 53072 | BERKSHIRE LIFE INSURANCE COMPANY OF AMERICA | $0 | $8K | $8K | 6.82% |
| MICHAEL L. SCOTT3 | 3805 SHOREBIRD COURT OSHKOSH, WI 54904 | BERKSHIRE LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 5.64% |
| MICHAEL L. SCOTT3 | 3805 SHOREBIRD COURT OSHKOSH, WI 54904 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 7.22% |
| SCOT J MADSON3 Filed as: SCOT J. MADSON | 3601 LOST DAUPHIN ASHWAUBENON, WI 54115 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 7.22% |
| THIRD COAST ADVISORS INC3 Filed as: THIRD COAST ADVISORS, INC. | 1166 QUAIL COURT, SUITE 100 PEWAUKEE, WI 53072 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $30 | $0 | $30 | 0.14% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Long-term disability(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,660 | $349K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,660 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.