| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RX BENEFITS3 Filed as: RX BENEFITS, INC. | 3700 COLONNADE PKWY STE. 600 BIRMINGHAM, AL 35243 | RXBENEFITS, INC. | — | $2K | $2K | 0.26% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | PO BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 10.66% |
| COMPASS BENEFITS LLC3 Filed as: COMPASS BENEFITS SPECIALIST INC. | 1205 CEDAR RD. KRONENWETTER, WI 54455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $959 | — | $959 | 2.61% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR. STE. 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $683 | $683 | 1.86% |
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 12.92% |
| COMPASS BENEFITS LLC3 Filed as: COMPASS BENEFIT SPECIALIST INC. | 1205 CEDAR RD. KRONENWETTER, WI 54455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $768 | — | $768 | 2.34% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR. STE. 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $606 | $606 | 1.85% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | PO BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 15.09% |
| COMPASS BENEFITS LLC3 Filed as: COMPASS BENEFIT SPECIALIST INC. | 1205 CEDAR RD. KRONENWETTER, WI 54455 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $988 | — | $988 | 4.67% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SRVS LLC | 501 OFFICE CENTER DR. STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $448 | $448 | 2.12% |
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 549520389 | WYSSTA INSURANCE COMPANY INC | $1K | — | $1K | 6.60% |
| COMPASS BENEFITS LLC3 | 1205 CEDAR RD. MOSINEE, WI 54455 | WYSSTA INSURANCE COMPANY INC | $527 | — | $527 | 3.43% |
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 | 206 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 131 | $15K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $37K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $33K |
| Prescription drug | RXBENEFITS, INC. | 138 | $718K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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.