| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR MOUNT PLEASANT, WI 53406 | NETWORK HEALTH INC | $38K | $4K | $42K | 6.00% |
| JOHNSON INSURANCE SERVICES LLC3 | 525 JUNCTION RD MADISON, WI 53717 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.23% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR MOUNT PLEASANT, WI 53406 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $249 | $2K | 19.50% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR MOUNT PLEASANT, WI 53406 | WYSSTA INSURANCE COMPANY INC | $734 | — | $734 | 8.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 THIRD PARTY ADMINISTRATO | Contract Administrator; Claims processing Service code 12 | — | $7K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | — | $6K |
| WILLIS OF WISCONSIN INC BROKER | Insurance agents and brokers Service code 22 | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | $75 |
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 | 112 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NETWORK HEALTH INC | 110 | $696K |
| Vision | WYSSTA INSURANCE COMPANY INC | 92 | $9K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 186 | $100K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 186 | $100K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 186 | $100K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 379 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 379 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.