| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PRAIRIE STATES ENTERPRISES, INC.3 | 35 EAST WACKER DRIVE STE 3200 CHICAGO, IL 60601 | HCC LIFE INSURANCE CO. | $50K | — | $50K | 11.13% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $473 | $2K | 10.62% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES-WI | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $639 | — | $639 | 3.66% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $315 | $315 | 1.81% |
| USI INSURANCE SERVICES LLC3 Filed as: USI LLC - WI ABRC | 711 EISENHOWER DRIVE KIMBERLY, WI 541360000 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $1K | — | $1K | 10.00% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $582 | $2K | 11.80% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $388 | $388 | 2.72% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES-WI | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $326 | — | $326 | 2.29% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $5K |
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 | 173 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 49 | $15K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 157 | $32K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE CO. | 72 | $451K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 157 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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.
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.