| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN/JOHNSON | 700 REGENT ST PO BOX 259408 MADISON, WI 53725 | PHYSICIANS PLUS INSURANCE CORP | $22K | $1K | $23K | 1.15% |
| INGENIUM PRIME INC3 | PO BOX 259408 MADISON, WI 537159408 | DELTA DENTAL OF WISCONSIN | $18K | — | $18K | 10.99% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INSURANCE, INC | 700 REGENT ST MADISON, WI 537152634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 7.27% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.60% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INSURANCE, INC | 700 REGENT ST MADISON, WI 537152634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.30% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 3.11% |
| HAUSMANN-JOHNSON INSURANCE INC3 | PO BOX 259408 MADISON, WI 537159408 | WYSSTA INSURANCE COMPANY INC | $2K | — | $2K | 9.99% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INSURANCE, INC | 700 REGENT ST MADISON, WI 537152634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $606 | $606 | 2.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSSING | Contract Administrator; Claims processing Service code 12 | — | $11K |
| HAUSMANN-JOHNSON INSURANCE, INC. BROKER | Insurance agents and brokers Service code 22 | 700 REGENT ST PO BOX 259408 MADISON, WI 53725 | $535 |
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 | 328 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 332 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PHYSICIANS PLUS INSURANCE CORP | 494 | $2.0M |
| Dental | DELTA DENTAL OF WISCONSIN | 240 | $162K |
| Vision | WYSSTA INSURANCE COMPANY INC | 176 | $24K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 328 | $21K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 188 | $52K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 328 | $38K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 328 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 494 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.