| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANSAY & ASSOCIATES LLC3 | 702 HIGH POINT RD STE 201 MADISON, WI 53717 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $25K | — | $25K | 1.28% |
| ANSAY & ASSOCIATES LLC3 | 2901 W BELTLINE HWY STE 202 MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $9K | — | $9K | 6.64% |
| ANSAY & ASSOCIATES LLC3 | 101 E GRAND AVE STE 11 PORT WASHINGTON, WI 53074 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 2.72% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9201 AUSTIN, TX 78766 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $399 | $399 | 0.91% |
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 | 176 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 300 | $2.0M |
| Dental | DELTA DENTAL OF WISCONSIN | 129 | $141K |
| Short-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 167 | $44K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 300 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 300 | — |
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.