| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIASTAR LIFE INSURANCE COMPANY | $83K | $0 | $83K | 8.01% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | RELIASTAR LIFE INSURANCE COMPANY | $46K | $0 | $46K | 4.42% |
| 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 | $6K | $6K | 5.68% |
| SCOTT J. MADSON3 | 111 NORTH WASHINGTON STREET GREEN BAY, WI 54301 | BERKSHIRE LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 5.59% |
| MICHAEL L. SCOTT3 | 1488 WEST SOUTH PARK AVENUE OSHKOSH, WI 54902 | BERKSHIRE LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 4.25% |
| NICOLET NATIONAL BANK - THE GUARDIA3 Filed as: NICOLET NATIONAL BANK | 7 HANOVER SQUARE NEW YORK, NY 10004 | BERKSHIRE LIFE INSURANCE COMPANY OF AMERICA | $71 | $0 | $71 | 0.07% |
| MICHAEL L. SCOTT3 | 3805 SHOREBIRD COURT OSHKOSH, WI 54904 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 7.19% |
| SCOTT J. MADSON3 | 3601 LOST DAUPHIN ASHWAUBENON, WI 54115 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 7.19% |
| THIRD COAST ADVISORS INC3 Filed as: THIRD COAST ADVISORS INC. | UNKNOWN NEENAH, WI 54956 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $29 | $0 | $29 | 0.07% |
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 | 1,870 | 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) | 1,870 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 4,810 | $1.0M |
| Long-term disability(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 4,810 | $1.2M |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 4,810 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,810 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.