| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BARRON P. RICHTER3 Filed as: BARRON P RICHTER | HAUSMANN-JOHNSON INSURANCE INC 700 REGENT ST. MADISON, WI 537259408 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $37K | — | $37K | 3.86% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN-JOHNSON INSURANCE, INC. | P.O. BOX 25940 MADISON, WI 53725 | DEAN HEALTH PLAN INC | $5K | — | $5K | 2.24% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INSURANCE INC | PO BOX 259408 MADISON, WI 537259408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $10K | 8.05% |
| HAUSMANN-JOHNSON INSURANCE INC3 | PO BOX 259408 MADISON, WI 537159408 | DELTA DENTAL OF WISCONSIN | $12K | — | $12K | 11.38% |
| HAUSMANN-JOHNSON INSURANCE INC3 | PO BOX 259408 MADISON, WI 53725 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | $765 | — | $765 | 9.05% |
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 | 253 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 262 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | 209 | $1.2M |
| Dental | DELTA DENTAL OF WISCONSIN | 114 | $103K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | 114 | $8K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 253 | $118K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 253 | $118K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 253 | $118K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 253 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 253 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.