| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCHWARZ INSURANCE AGENCY INC3 | 1420 N RIDGE DR PRAIRIE DU SAC, WI 53578 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $14K | — | $14K | 1.05% |
| R & R INSURANCE SERVICES INC3 | N 14 W23900 STONE RIDGE DR WAUKESHA, WI 53188 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $7K | — | $7K | 0.55% |
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY, INC | 1420 NORTH RIDGE DR. PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $586 | $4K | 6.81% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 5.43% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES INC | N14W23900 STONE RIDGE DR WAUKESHA, WI 53188 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 4.21% |
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY, INC | 1420 NORTH RIDGE DR. PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $567 | $5K | 10.02% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES INC | N14W23900 STONE RIDGE DR WAUKESHA, WI 53188 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 6.04% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 5.40% |
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY, INC | 1420 NORTH RIDGE DR., P.O. BOX 40 PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $255 | $2K | 9.71% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES INC | N14W23900 STONE RIDGE DR WAUKESHA, WI 53188 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 6.31% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.42% |
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY | 1420 NORTH RIDGE DRIVE PRAIRIE DU SAC, WI 53578 | METROPOLITAN LIFE INSURANCE COMPANY | $677 | $283 | $960 | 8.51% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $512 | $205 | $717 | 6.36% |
| R & R INSURANCE SERVICES INC3 Filed as: R&R INSURANCE SERVICES INC | N14W23900 STONE RIDGE DR WAUKESHA, WI 53188 | METROPOLITAN LIFE INSURANCE COMPANY | $346 | — | $346 | 3.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | — | $5K |
| R & R INSURANCE SERVICES INC INS AGENTS AND BROKERS | Insurance agents and brokers Service code 22 | N14 W23900 STONE RIDGE DR WAUKESHA, WI 53188 | $716 |
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 | 132 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 182 | $1.3M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 76 | $11K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 128 | $53K |
| Short-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 128 | $58K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 129 | $25K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 182 | $1.3M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 128 | $54K |
| 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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.