| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 555 MAIN ST, SUITE 320 RACINE, WI 53403 | ACE AMERICAN INSURANCE COMPANY | $21K | — | $21K | 6.63% |
| NATIONAL MEDICAL EXCESS LLC3 Filed as: NATIONAL MEDICAL EXCESS, LLC | 3018 S REPUBLIC BLVD, SUITE 200 TOLEDO, OH 43615 | ACE AMERICAN INSURANCE COMPANY | $16K | — | $16K | 5.03% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 2725 S MOORLAND RD NEW BERLIN, WI 53151 | ACE AMERICAN INSURANCE COMPANY | $16K | — | $16K | 5.03% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 555 MAIN STREET, SUITE 320 RACINE, WI 53403 | GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 13.31% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 2725 S MOORLAND RD NEW BERLIN, WI 53151 | GUARDIAN LIFE INSURANCE COMPANY | $265 | — | $265 | 2.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE CO EIN 36-2739571 NONE | Claims processing Service code 12 | P O BOX 30555 SALT LAKE CITY, UT 84130 | $157K |
| HEALICS, INC EIN 39-1828314 NONE | Direct payment from the plan Service code 50 | 8919 W. HEATHER AVE MILWAUKEE, WI 53224 | $10K |
| GUARDIAN LIFE INSURANCE COMPANY | Claims processing Service code 12 | P O BOX 677458 DALLAS, TX 75267 | $8K |
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 | 217 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY | 217 | $11K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY | 217 | $11K |
| Stop-loss / reinsurancereinsurance | ACE AMERICAN INSURANCE COMPANY | 179 | $322K |
| Other | GUARDIAN LIFE INSURANCE COMPANY | 217 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.