| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR MOUNT PLEASANT, WI 53406 | NETWORK HEALTH PLAN | $35K | — | $35K | 4.64% |
| JOHNSON INSURANCE SERVICES LLC3 | 525 JUNCTION RD MADISON, WI 53717 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.19% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR MOUNT PLEASANT, WI 53406 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $161 | $2K | 12.40% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR MOUNT PLEASANT, WI 53406 | WYSSTA INSURANCE COMPANY INC | $698 | — | $698 | 7.79% |
| 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 | — | $2K |
| JOHNSON INSURANCE SERVICES LLC BROKER | Insurance agents and brokers Service code 22 | 1103 HUNTER DR SUITE 100 MOUNT PLEASANT, WI 53406 | $43 |
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 | 318 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 327 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NETWORK HEALTH PLAN | 103 | $751K |
| Vision | WYSSTA INSURANCE COMPANY INC | 90 | $9K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 199 | $123K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 199 | $123K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 199 | $123K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 318 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 318 | — |
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."
No prospect flags tripped on this filing.