| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FORSITE BENEFIT PARTNERS3 Filed as: FORSITE BENEFIT PARTNERS LLC | 2300 RIVERSIDE DR. GREEN BAY, WI 54301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $627 | $3K | 18.89% |
| FORSITE BENEFIT PARTNERS3 | 2300 RIVERSIDE DR GREEN BAY, WI 54301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $255 | $2K | 16.78% |
| FORSITE BENEFIT PARTNERS3 Filed as: FORSITE BENEFITS | 2300 RIVERSIDE DR SUITE 204 GREEN BAY, WI 54301 | WYSSTA INSURANCE COMPANY INC | $518 | — | $518 | 7.97% |
| FORSITE BENEFIT PARTNERS3 | 2300 RIVERSIDE DR GREEN BAY, WI 54301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $813 | $65 | $878 | 16.21% |
| FORSITE BENEFIT PARTNERS3 | 2300 RIVERSIDE DR. GREEN BAY, WI 54301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $523 | $239 | $762 | 14.56% |
| UNITED OF OMAHA LIFE INSURANCE CO5 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 95.43% |
| FORSITE BENEFIT PARTNERS3 Filed as: FORSITE BENEFIT PARTNERS LLC | 2300 RIVERSIDE DR. GREEN BAY, WI 54301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $102 | $102 | 4.57% |
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 | 111 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 66 | $6K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $21K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $2K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 67 | $14K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.